Neck lymph nodes of peanut size have not changed for ten years, may be caused by physiological factors, may also be caused by lymph node tuberculosis and other pathological factors, physiological factors do not need treatment, lymph node tuberculosis and other pathological factors need to be combined with general treatment, rifampicin and other drugs treatment. 1. Physiological factors: the size of a peanut in the neck lymph nodes, if there is no change in ten years, and the surrounding tissues are not adherent, without any other symptoms, considering physiological factors, such as the original lymph node inflammation has been healed, but the formation of fibrotic parcels, do not need treatment, only need to follow up and observe can be. 2. Lymph node tuberculosis: Lymph node tuberculosis can also lead to enlargement of peanut-sized cervical lymph nodes, which can be relatively static with no obvious change in size when the body has good immune function. However, it is usually accompanied by low-grade fever, night sweats, weight loss, cough and sputum. In this case, it is necessary to take isoniazid, rifampicin and other drugs for long-term anti-tuberculosis treatment. A high-protein and high-nutrition diet is needed to maintain body weight and increase immunity to avoid repeated colds. If the lymph nodes in the neck are the size of peanuts and have remained unchanged for ten years, there may be other reasons, so it is recommended to consult a doctor in time to find out the cause and treat the cause. The above medication is in accordance with the doctor’s prescription.