Computed tomography of the clinically negative neck

✍ Scribed by John Watkinson; Omar Shaheen; N. P. McIvor; R. P. Morton; E. B. Dorman; Carl E. Silver

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 309 KB
• Volume: 13
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.2880130113

✦ Synopsis

We welcome the critical analysis of our recent paper and hope the following points clarify the situation: staging system to correlate the position of any malignant nodes found by neck dissection.' found CT slightly less accurate Feinmesser et 1. The chest x-rays of all 4 patients did not show any of the changes normally associated with pulmonary tuberculosis, and sputum cultures in all 4 cases were negative for Mycobacterium tuberculosis. 2. The diagnoses of active nodal tuberculosis were all based on positive culture for Mycobacterium tuberculosis of nodal tissue and Ziehl-Neelsen staining for alcohol acid-fast bacilli. 3. In 2 patients, both metastatic squamous cell carcinoma and tuberculous granulomas were found to coexist within the same lymph nodes. In the other 2 patients these pathologies were identified in separate lymph nodes. 4. All 4 patients were treated with anti-tuberculous chemotherapy.

As mentioned in the text, many local or systemic diseases, some of which may produce granulomatous change, can result in lymph node enlargement and, consequently, a false-positive assessment of the cervical nodes. 5. Dr. Ophir's list of potential pathologies, which can produce granulomatous change, is a useful reminder of some of these conditions.