A 22-year-old woman has multiple firm, matted, non-tender lymph nodes in the right jugulodigastic region for two months, with evening fever and weight loss. FNAC shows epithelioid granulomas with central caseation necrosis. What is the most likely diagnosis?
- A Tuberculous cervical lymphadenitis ✓
- B Hodgkin lymphoma
- C Metastatic papillary thyroid carcinoma
- D Rosai-Dorfman disease
Correct answer: A. Tuberculous cervical lymphadenitis
Explanation
Caseating granulomatous inflammation on FNAC in a young patient with constitutional symptoms and matted jugulodigastic nodes is diagnostic of tuberculous cervical lymphadenitis, the most common cause of chronic cervical lymphadenopathy in India. Matting results from periadenitis binding nodes together. Hodgkin lymphoma yields Reed-Sternberg cells without caseation, metastatic papillary carcinoma shows papillary clusters with nuclear inclusions, and Rosai-Dorfman disease shows emperipolesis of histiocytes.
Reference: Diseases of Ear, Nose and Throat (Dhingra), 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.