Original Article

Computed Tomographic Differential Diagnosis of Cervical Lymphadenopathy: Tuberculous versus Metastatic

Eun A Kim*, Soo Mee Lim**, Chung Sik Rhee***
Author Information & Copyright
*Department of Diagnostic Radiology, National Cancer Center, Korea.
**Department of Radiology, Mokdong Hospital, Ewha Womans University, Korea.
***Department of Radiology, Dongdaemoon Hospital, Ewha Womans University, Korea.

Copyright ⓒ 2002. Ewha Womans University School of Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Sep 30, 2002



To determine the computed tomographic findings of cervical lymphadenopathy which distinguish tuberculous lymphadenitis from metastatic lymphadenopathy.

Materials and Methods

We retrospectively analyzed the CT findings of 21 patients with tuberculous lymphadenitis and 19 with metastatic lymphadenopathy in terms of location, size, shape, presence and shape of necrosis, and presence of extranodal extension.


The tuberculous lymphadenopathy was predominantly located in spinal accessory chain(level V)(42%), but metastatic lymphadinopathy was predominantly located in internal jugular chain(level II)(37%). Of the 21 patients with tuberculous lymphadenitis, the shape was conglomerated lesion with irregular margin in 13 cases. Of the 19 patients with metastatic lymphadenopathy, conglomerated lesion in 4 cases, which were statistically significant(p<0.05). The presence of central necrosis was more frequent in tuberculous lymphadenitis(n=20) than metastatic lymphadenopathy(n=11)(p<0.05). The presence of extranodal extension was significantly different between tuberculous(n=19) and metastatic lymphadenopathy(n=1)(p<0.05).


Cervical tuberculous lymphadenitis frequently involves the spinal accessory chain in young woman. The irregular conglomerated lesion with irregular central necrosis and extranodal extension on CT scan is suggestive of cervical tuberculous lymphadenitis, which is useful in differentiating from metastatic lymphadenopathy.

Keywords: CT; Tuberculosis; Metastasis