Tuberculosis of the lymph glands of the neck: a limited role for surgery.

BACKGROUND AND OBJECTIVE: The clinical problem of a neck mass in general and tuberculous lymph nodes in the neck in particular may present a diagnostic dilemma. This retrospective study was conducted to highlight clinical presentation, management, and outcome. PATIENTS AND METHODS: All patients (n = 59) diagnosed with tuberculosis of the cervical lymph node in Irbid governorate during the period 1996 through 2000 were reviewed for standard criteria, in addition to diagnostic and therapeutic modalities. RESULTS: Medical records were reviewed and relevant data were included; all age groups were equally involved with a female/male ratio of 2:1. Most of the patients presented with a neck mass to the outpatient surgical clinic. The diagnosis was made mainly based on the clinical picture and results of the Mantoux test, Ziehl-Neelsen staining, and culture of bacilli. Fine needle aspiration cytology and histologic examination of incisional or excisional specimens are the main objective diagnostic tools. All patients were treated with antituberculous drugs under directly observed therapy short-course regimen with 83% cure rate. CONCLUSION: Tuberculosis of the cervical lymph nodes responds well to antituberculous drugs and the surgical role is limited to guidance in fine needle aspiration, incision and drainage, and incisional and limited excisional biopsy. Major excisional procedures are not without complications and should be avoided.