Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, this patient should start anti tubercular drugs according to weight. Tubercular Lymphadenopathy is much more common than sarcoidosis. Sarcoidosis is more common in mediastinal lymphnode. TB is more common in cervical lymphnode. So even if culture is negative, absence of caseation necrosis, we should definitely go for anti tubercular drugs for atleast 6-8 months. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks.