Answer: C. Lymphadenitis

Diagnosis: Tuberculosis Cervical Lymphadenitis (Scrofula)

• Scrofula results from reactivation of prior TB at a site that acquired TB from hematogenous seeding during primary (TB) infection. This can happen years earlier.
• The most common presentation is in young adults with unilateral, chronic, nontender lymphadenopathy. Systemic symptoms are not common.
• The mass may be present for up to 12 months before diagnosis.
• Physical examination reveals a firm, discrete mass or matted nodes fixed to surrounding structures.
• Cervical lymphadenitis is the most common manifestation of tuberculous lymphadenitis.
• While CT imaging can have classic findings of scrofula, the diganosis is made by fine needle aspiration, excisional biopsy, and culture with PCR testing
• Treatment of tuberculosis lymphadenitis will consist of multi-drug therapy depending on sensitivities.

References:
1. Spelman, D. "Tuberculosis lymphadenitis." UpToDate. July 2016.