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Ngo Pambe CJ, Onana Y, Essame Oyono JL, Ongolo Zogo P, Mendimi JM. [Primary tuberculosis of the cavum: An unusual diagnosis]. Ann Pathol 2023; 43:483-486. [PMID: 36948994 DOI: 10.1016/j.annpat.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/24/2023]
Abstract
Primary tuberculosis of the cavum is a rare entity. It can occur at any age, especially between the second and ninth decade. We report the case of a 17-years-old patient with nasal obstruction and left laterocervical adenomegaly. A cervico-facial CT scan showed a suspicious looking tumor process of the nasopharynx. Histological analysis of the biopsies taken showed chronic granulomatous inflammation with necrosis and the absence of tuberculosis lesions in the usual sites, especially the lungs, led to the diagnosis of primary tuberculosis of the cavum. There was a good evolution on antituberculosis drugs. This unusual location can be a source of difficulties and delay in diagnosis, especially because of the clinical presentation, which suggests a nasopharyngeal tumour. In developing countries, where this disease remains relatively endemic, cross-sectional imaging techniques and histopathological analysis are of great interest for the management of patients.
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Affiliation(s)
- Christiane Judith Ngo Pambe
- Département des sciences morphologiques et d'anatomie pathologique, faculté de médecine et des sciences biomédicales, université de Garoua, 317 Garoua, Cameroun.
| | - Yannick Onana
- Département de radiologie et d'imagerie médicale, faculté de médecine et des sciences biomédicales, université de Garoua, 317 Garoua, Cameroun
| | - Jean-Louis Essame Oyono
- Département des sciences morphologiques et d'anatomie pathologique, faculté de médecine et des Sciences biomédicales, université de Yaoundé I, 1634 Yaoundé, Cameroun
| | - Pierre Ongolo Zogo
- Département de radiologie et d'imagerie médicale, faculté de médecine et des sciences biomédicales, université de Yaoundé I, 1634 Yaoundé, Cameroun
| | - Joseph Marie Mendimi
- Département des sciences morphologiques et d'anatomie pathologique, faculté de médecine et des Sciences biomédicales, université de Yaoundé I, 1634 Yaoundé, Cameroun
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Büchel AS, Jungehülsing M, Schumacher T. [Chronic bilateral mesotympanitis]. HNO 2023; 71:526-529. [PMID: 37154915 PMCID: PMC10403393 DOI: 10.1007/s00106-023-01302-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 05/10/2023]
Affiliation(s)
| | - Markus Jungehülsing
- Ernst-von-Bergmann-Klinikum, Charlottenstr. 72, 14467, Potsdam, Deutschland.
| | - Tillmann Schumacher
- Ernst-von-Bergmann-Klinikum, Charlottenstr. 72, 14467, Potsdam, Deutschland.
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Sidam S, Sahoo AK, Gupta V, Khurana U. Varied Presentation of Oropharyngeal Tuberculosis: Review of Cases. Cureus 2023; 15:e43636. [PMID: 37719636 PMCID: PMC10504869 DOI: 10.7759/cureus.43636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Tuberculosis (TB) is a chronic granulomatous infectious disease with 25% morbidity due to extrapulmonary form. Hence, knowledge about varied presentations of extrapulmonary oropharyngeal type may help in early diagnosis and management in acute as well as chronic settings. This article describes immunocompetent patients' presentation with varied oropharyngeal manifestations and later diagnosed with tuberculous tonsillitis and tuberculous abscesses with Pott's spine. The varied manifestation of oropharyngeal TB, which is supposed to be a chronic condition, may help in early diagnosis in acute and chronic settings.
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Affiliation(s)
- Shaila Sidam
- Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, Bhopal, IND
| | - Anjan K Sahoo
- Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, Bhopal, IND
| | - Vikas Gupta
- Otorhinolaryngology, All India Institute of Medical Sciences, Bhopal, IND
| | - Ujjawal Khurana
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, IND
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Misirovs R, Johnston L, Green R. Primary nasopharyngeal tuberculosis. BMJ Case Rep 2022; 15:e251927. [PMID: 36593611 PMCID: PMC9730391 DOI: 10.1136/bcr-2022-251927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
No part of the human body is immune to tuberculosis, the most common site being the lungs. We report a rare case of primary nasopharyngeal tuberculosis without cervical lymphadenopathy nor pulmonary involvement. The only presenting symptom was an intermittent discomfort in the neck and throat. Several biopsies were performed to exclude nasopharyngeal carcinoma and to reach the final diagnosis of tuberculosis. The patient made full recovery following 6 months of treatment with antibiotics. A multidisciplinary approach by ear, nose and throat, radiology, pathology, and infectious disease colleagues was crucial in reaching the diagnosis and managing the patient.
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Affiliation(s)
- Rasads Misirovs
- Scottish Centre for Respiratory Research, University of Dundee, Dundee, UK
- Doctoral studies, Riga Stradins University, Riga, Latvia
| | - Lisa Johnston
- Department of Histopathology, Ninewells Hospital and Medical School, Dundee, UK
| | - Richard Green
- Department of Otorhinolaryngology, Ninewells Hospital and Medical School, Dundee, UK
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Tuberculosis of the middle ear: A systematic review. Am J Otolaryngol 2022; 43:103571. [DOI: 10.1016/j.amjoto.2022.103571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022]
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Mocanu AI, Mocanu H, Moldovan C, Soare I, Niculet E, Tatu AL, Vasile CI, Diculencu D, Postolache PA, Nechifor A. Some Manifestations of Tuberculosis in Otorhinolaryngology - Case Series and a Short Review of Related Data from South-Eastern Europe. Infect Drug Resist 2022; 15:2753-2762. [PMID: 35668856 PMCID: PMC9166903 DOI: 10.2147/idr.s367885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Tuberculosis is a disease of global outreach that may affect the entire human body but is most commonly located in the lungs. Otorhinolaryngological manifestations of tuberculosis are rare, mostly occurring secondary to pulmonary disease but nevertheless represent significant diagnostic challenges. Nasopharyngeal tuberculosis is rare, representing around 1% of all upper air-way localizations and the most common presentation is in the form of adenoids. Tuberculous glossitis (oral tuberculosis) is even scarcer and may present in various clinical forms, usually mimicking a malignant neoplasm, or, less often, trauma or other infectious lesions. Oropharynx tuberculosis is usually misdiagnosed as hypertrophic chronic tonsillitis. We present four rare cases of ENT tuberculosis, primary adenoiditis and tonsillitis in a 13-year-old girl, a curious case of tuberculous glossitis in a 65-year-old woman, clinically diagnosed as a lingual neoplasm and two cases of tuberculous lymphadenopathy uncommonly located in the submandibular and supraclavicular regions. A comprehensive review of literature follows the case presentations. Tuberculous manifestation in the ear, nose and throat area remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of pharynx lesions. An early diagnosis is essential to avoid occurrence of complications.
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Affiliation(s)
| | - Horia Mocanu
- Department of ENT & HNS, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, Romania
| | - Cosmin Moldovan
- Faculty of Medicine, “Titu Maiorescu” University of Bucharest, Bucharest, Romania
- General Surgery Ward, ‘Witting’ Clinical Hospital, Bucharest, Romania
| | - Ioana Soare
- Faculty of Medicine, “Titu Maiorescu” University of Bucharest, Bucharest, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Claudiu Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Daniela Diculencu
- Medical Analysis Laboratory, Clinical Pneumoftisiology Hospital, Iasi, Romania
| | - Paraschiva A Postolache
- Clinical Medical Department, Faculty of Medicine, “Grigore T Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
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Raj R, Sud P, Saharan N, Virk RS. Laryngeal tuberculosis: a neglected diagnosis. BMJ Case Rep 2022; 15:e248095. [PMID: 35131802 PMCID: PMC8823138 DOI: 10.1136/bcr-2021-248095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2021] [Indexed: 11/04/2022] Open
Abstract
A 24-year-old woman visited the Ear Nose Throat (ENT) outpatient department with complaints of hoarseness for 2 months not responding to conservative management. Laryngoscopic examination revealed a whitish ulceroproliferative lesion in the anterior commissure and anterior two-thirds of bilateral true vocal cords with surrounding necrosis. In view of the above findings, the patient was planned for biopsy under general anaesthesia. Intraoperative findings showed multiple whitish necrotic friable tissue involving anterior two-thirds of bilateral false vocal cords, ventricle, bilateral true vocal cords, both aryepiglottic folds and laryngeal surface of epiglottis. Postoperative histopathology was consistent with tuberculosis. A pulmonology consultation was taken, and the patient was started on anti-tuberculosis chemotherapy. One month post therapy, the voice was symptomatically better. A flexible fibreoptic laryngoscopic examination was done, which revealed almost complete resolution of the lesion with minimal ulceration at the anterior one-third of right true vocal cord.
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Affiliation(s)
- Reshma Raj
- ENT, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Parul Sud
- ENT, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Neha Saharan
- Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ramandeep Singh Virk
- ENT, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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