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Tuberculous cervical lymphadenitis in a patient with laryngeal carcinoma

Published online by Cambridge University Press:  03 August 2009

S Al-Zahid  and
V Singh
S Al-Zahid*
Affiliation:
Otolaryngology Department, Princess of Wales Hospital, Bridgend, Wales, UK
V Singh
Affiliation:
Otolaryngology Department, Princess of Wales Hospital, Bridgend, Wales, UK
*
Address for correspondence: Dr Saif Al-Zahid, 13 Grafton Close, Penylan, Cardiff CF23 9JA, Wales, UK. E-mail: alzahids@doctors.org.uk
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Abstract

Objective:

We report an extremely rare presentation of concomitant tuberculous cervical lymphadenitis in a patient with carcinoma of the larynx.

Case report:

A 66-year-old man presented with a nine-month history of hoarseness. He was found to have an exophytic lesion over the posterior half of the right vocal fold. He also had a palpable right jugulodigastric node. Biopsy of the vocal fold lesion revealed invasive squamous cell carcinoma. Histological analysis of an excision biopsy specimen from the lymph node was highly suggestive of tuberculosis. On further assessment of the slides, one acid-fast bacillus was seen. The patient was treated with radiotherapy to the larynx and concomitant anti-tuberculosis chemotherapy. Five months following treatment, there was no sign of laryngeal cancer recurrence; however, the patient continued to have a productive cough and night sweats.

Conclusion:

To our knowledge, this is the first report of a laryngeal carcinoma with concurrent tuberculous cervical lymphadenitis. In the face of an unhelpful fine needle aspiration cytology examination, an assumption of metastatic neck disease could have been made. Subsequent surgical and/or oncological intervention would have been highly inappropriate, with potentially catastrophic effects. This case highlights the importance of proper diagnosis, and emphasises the fact that tuberculosis should always be borne in mind in the differential diagnosis.

Keywords

TuberculosisHead And Neck NeoplasmsTumour MetastasisDiagnosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 1 , January 2010 , pp. 90 - 92
Copyright
Copyright © JLO (1984) Limited 2009

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