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Cervical lymphadenopathy with packet formation as the sole presentation of tuberculosis is very rarely seen in modern Japan. During the four years from 1987 to 1990, 5 cases of cervical scrofula with packet formation were treated with selective neck dissection followed by antituberculous chemotherapy at the ENT-department of Haibara General Hospital. Clinical evaluation of these cases suggested the following: 1) The physician must keep in mind that cervical scrofula should be included in the differential diagnosis of any neck masses, and malignant neck tumors particularly should be differentiated from cervical scrofula. 2) The treatment of cervical scrofula should be appropriate to the clinical stage diagnosed by CT or MRI. Recommended therapy for cervical scrofula with packet formation is selective neck dissection followed by antituberculous chemotherapy, which can shorten the period of treatment. 3) We present here a 22-year-old female from the Philippines with cervical scrofula and suggest that, in the future in Japan, tuberculosis may frequently be encountered in the immigrant population from the countries with high incidences of tuberculosis.

Clinical issues of tuberculous cervical lymphadenitis: Evaluation of 5 cases with packet formation.