Modern management of cervical scrofula

From 1970 to 1984, 32 patients were treated for tuberculous (TB) masses, which measured 1.2-5.5 cm. The posterior triangle was involved in 19 patients, anterior triangle in 7, and more than one triangle in 6 (3 bilateral). A superficial node was excised for diagnosis. Acid-fast bacilli were identified on the smear of 18 patients. Caseation necrosis was present in 27 specimens, sarcoidosis in four, nonspecific lymphadenitis in one; all cultures grew Mycobacterium tuberculosis. A chest x-ray showed no active TB. Chemotherapy was given for 9-18 months (9 months when only one node was diseased and 18 months with extensive nodal involvement). Follow-up examinations in all patients (greater than 3 years, mean 8.6 years) has revealed no recurrence. The need to excise all cervical TB nodes, chronically inflamed and often fused to important structures, was eliminated by adequate chemotherapy.