Treatment of tuberculous masses in the neck.

Tuberculous cervical lymphadenitis was diagnosed in 23 patients from 1970 to 1980; 21 of them were immigrants. The masses ranged in diameter from 1.5 to 5.5 cm. The posterior triangle was involved in 11 patients, the anterior triangle in 7 and both triangles in 5 (3 bilateral). Excisional node biopsy was performed in all. Acid-fast bacilli were identified on the smear in only 12 patients. Caseation necrosis was present in 19 specimens; the other 4 were comparable with sarcoidosis. However, all cultures grew Mycobacterium tuberculosis, which was corroborated in all by guinea-pig inoculation. No chest roentgenograms showed active pulmonary tuberculosis. Chemotherapy was given for 12 to 18 months. In three patients masses continued to enlarge for 5 months after initiation of chemotherapy, but then regressed and disappeared completely within 12 months. No recurrences were present in any patients (follow-up more than 2.5 years, mean 5.4 years).