Cervical lymphatic tuberculosis is called “scrofula” in Chinese medicine and is most commonly seen in children and young adults. It usually develops when the body’s resistance to disease is low. Most of the cases are secondary to tuberculosis lesions. There may be multiple enlarged lymph nodes of different sizes in the neck unilaterally or bilaterally. Initially, the enlarged lymph nodes are hard, painless, and pushable. As the lesion progresses, adhesions to the skin and surrounding tissues occur due to perilymph node inflammation, and individual lymph nodes may also adhere to each other and fuse into clusters. In the late stage, the lymph nodes undergo caseous necrosis and liquefaction, forming cold abscesses. After rupture, pus like bean curd or rice soup can flow out, and finally a long-lasting sinus tract or chronic ulcer is formed. Clinical manifestations 1.Some patients may have toxic symptoms such as low fever, weakness, cough, chest pain, night sweats and emaciation. 2, generally located unilaterally or bilaterally on the anterior and posterior edges of the sternocleidomastoid muscle with multiple enlarged lymph nodes of varying sizes, mostly in the bilateral neck, and in some patients on the clavicle. 3 Orthopantomogram of chest or CT of chest suggests patchy shadow on lung. Diagnostic differentiation 1. Tumor neck metastasis (left side is mostly seen in esophageal tumor. Right side is mostly seen in lung cancer. Mostly single enlarged lymph node) 2.Lymphoma (patients usually do not have symptoms of tuberculosis toxicity bone marrow aspiration can differentiate) 3.Lymphadenitis (patients mostly have fever, fire or toothache and other triggers) Diagnosis basis 1.Adolescent patients with recent symptoms of systemic toxicity such as hypothermia, night sweats, wasting, etc. 2.Single or bilateral sternocleidomastoid muscle with multiple enlarged lymph nodes at the anterior-posterior border. 3, The patient had poor anti-inflammatory treatment and the swollen lymph nodes shrank after anti-TB. 4. Biopsy is performed if necessary to confirm the diagnosis. Treatment principles 1.Appropriate attention to nutrition and rest. 2.Systemic anti-tuberculosis bacillus treatment. 3.If the enlarged lymph nodes do not shrink significantly after anti-TB treatment, combined with septicemia, or if sinus tracts are formed, surgery should be performed after half a month of intensive anti-TB treatment. Principles of surgical treatment and indications for surgery 1.Conservative medical treatment, but the enlarged lymph nodes do not shrink significantly. 2.The diagnosis is not completely clear and biopsy is needed. 3.The lymph nodes have become septic, the local skin is red or broken, and there is local fluctuation on palpation. Surgery is needed to remove the lesion and open drainage for drug exchange. 4.There is already sinus tract formation.