Hi and thank you so much for this query. I am so sorry to hear about this cervical lymph node and all the inconvenience this has caused you. Granulomatous inflammatory reactions are often caused by diseases like tuberculosis, sarcoidosis, Leprosy, Schistosomiasis, Histoplasmosis, cryptococcosis, Cat-scratch disease etc. This needs to be completed by a focused clinical evaluation to narrow down the cause to a few and orient for further investigations and management. For example, if you have been coughing and have fevers, we may think of tuberculosis. If you were bitten by a cat, it could raise the suspicion of cat s scratch disease, etc. TB is typically described as a caseous granuloma....I don t know whetehr this feature is absent or was not reported. So its treatment depends on so much more that we don t have now. What i will suggest is that you continue with your doctor and he should be able to settle on a cause and treat accordingly. I hope you find this information helpful. I wish you all the best as you continue this process. Dr. Ditah, MD.