Supra clavicular lymphadenopathy

17F with C/O Pain around right side of neck and right supra clavicular swelling since a week. No H/O fever/weight loss/anorexia. How to investigate and manage further?

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Advise-cbc. Cbnatt. Xray chest pa view. Sputam for AFB. MT test. Usg whole abdomen and chest to evaluate medistinal and abdominal lymphadenopathy. Excisional biopsy of lymphnode. D/d-1-extrapulmonary tuberculosis.2-hodgkins lymmphoma. Non specific reactive adenopathy(idipathic) Rpt fnac.reports available then start tt.
U must send h/p/e and fnac, expert plus...as in fnac s/o epitheloud cell granuloma with or without langerhans giant cells with caseating necrosis..
Suggestive of TB rule out TB with chest x ray and sputum or cbnaat(best).. also look out for any signs n symptoms of any extra pulmonary TB...
Rule out tuberculosis After going all investigation if nothing comes out go for excision biopsy.to rule tuberculosis or any other cause.
Reactive nodal cytomorphology may be seen in TBC pathology..also. Sug. Clinico imaging correlation Cbnaat from fna. Ex bx
Excision biopsy will confirm the lesion yes it looks to be caseating necrosis in central part of lymphnode Tubercular adenitis
Thanx dr Pushkar ji Bhomia
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R/o tuberculosis Ad CBNAAT Sputum exam MT test ESR After results of reports start treatment
Rt supraclavicular LN R/O TB Lymphadenitis Cap Biodoxi 100mg bd×2weeks Tab Hifenac D bd×7days
Reactive lymphedenitis Rull out Kochs by doing CBNAAT from FNA Course of good antibiotics
Go for cbnaat Sputum for afb Need scan of the supraclavicular lympnode
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