Tubercular lymphadenitis

      A 46-year-old male presented with gradually progressive swelling and discharge from both sides of his neck of 2 months duration. He also had a history of intermittent low-grade fever and weight loss for 2 months. Examination revealed multiple matted, firm to soft swellings on both sides of the neck associated with discharging sinuses bilaterally (Figure 1). Ziehl-Neelson staining of the discharge revealed acid-fast bacilli. The lymph node along with the sinus tracts and overlying skin were excised and post histopathology of the specimen showed epithelioid cell cluster (white arrow) and multinucleated giant cells (black arrow) surrounded by lymphoid cells, confirmatory of tubercular lymphadenitis (Figure 2). The patient was started on anti-tubercular drugs, which continued for 6 months and he is asymptomatic at 1-year follow-up.
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