Excision biopsy of cervical lymphadenopathy on the right side in 2004 showed confluent epithelioid granulomas.  Areas of hyalinization and necrosis also seen.  Multinucleite giant cells of Langhans type noted.  Z-N staining did not reveal acid fast bacilli despite intensive search.  No atypical cells observed.  Diagnosis
Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, this patient should start anti-tubercular Chat Doctor. Tubercular Lymphadenopathy is much more common than acidosis. Acidosis is more common in mediastinal lymph node. TB is more common in cervical lymph node. So even if culture is negative, absence of cassation necrosis, we should definitely go for anti-tubercular