A pt with diabetic nephropathy and suspected disseminated TB
Tuberculosis (TB) and Non-Hodgkins lymphoma (NHL) share similar clinical and radiological features, which make diagnosis a challenge. It is often difficult to rule out a diagnosis of extrapulmonary and/or disseminated TB because of its paucibacillary nature and difficulty in accessing the involved organs.

In countries with high prevalence of TB like ours, empirical antitubercular treatment (ATT) is started, and the patient is followed up closely for response.

Published in the Indian Journal of Pathology and Microbiology, the authors present a rare case of a 54-year old diabetic male who was suspected to be a case of disseminated TB but had a rapid downhill course despite ATT. A postmortem revealed features of a rare, aggressive T-cell NHL masquerading as disseminated TB.

A 54-year-old male presented with 10 days' history of decreased appetite, dyspnea, and decreased urine output. Appetite was reduced, but there was no associated nausea, vomiting, diarrhea, pain abdomen, dysphagia/odynophagia, hematemesis, or hemoptysis.

The dyspnea was gradually progressive and associated with easy fatigability, but there was no history of chest pain, palpitations, orthopnea, or paroxysmal nocturnal dyspnea. He complained of decreased urine output but denied any history of dark-colored/smoky urine, hematuria, burning/pain during micturition, or passage of any stone/clots/flesh in urine. There was no history of fever.

He was a known case of diabetes mellitus (DM) type 2 since the last 10 years and had stopped oral hypoglycemic agents on his own about a month back. There was no history of hypertension, heart disease, tuberculosis (TB), or jaundice.

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