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An Atypical Presentation of Tuberculosis Lymphadenitis



Tuberculosis (TB), one of the oldest diseases of human, remains a global health problem especially in developing countries. Tuberculosis is classified as pulmonary or extra-pulmonary. Tuberculosis lymphadenitis is the most common form of extra-pulmonary TB. In this report, we presented a patient with TB lymphadenitis who had atypically multiple lymph node involvements similar to malignancies without complaints about a lung disease. An 81-year-old male presented with a three-month history of a growing swelling at cervical region. At last one-month, another swelling was occurred at right axillary region. Physical examination revealed multiple lymphadenopathies at cervical and axillary regions.  A computerized tomography (CT) revealed a lymphadenopathy at right axillary region 5 x 2 cm in diameter, a cystic mass or abscess at right posterior cervical region 3 x 2 cm in diameter and multiple lymphadenopathies at cervical regions. Thoracic tomography revealed fibroathelectasy, thicker fibrotic bands and increase of reticulo-nodular density at both lungs which were reported as reactivation of tuberculosis. An excisional biopsy was performed which revealed granulomatous inflammatory process with caseification. Asido-resistans bacteria were detected from microbiological assessment of both the pus of the mass and the nodular lesion via polymerase chain reaction(PCR). The diagnosis was reactivated tuberculosis lymphadenitis. Although multiple lymphadenopathies accompanied with weight loss refer to malignancies, tuberculosis must also be considered in differential diagnosis. 

30 Sep, 2015
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e-Published: 15 Mar, 2016


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