This case report follows a man that was diagnosed with tuberculosis in one hospital and 5 months later was diagnosed with malignant lymphoma in another hospital.
A classical case highlighting the importance of thoroughly reviewing patient's relevant medical information, specially pathological samples before jumping to popular diagnosis.
A 33-year-old Thai male presents with typical signs of tuberculous lymphadenitis, negative for both acid-fast bacilli and fungi, and negative polymerase chain reaction for Mycobacterial tuberculosis complex.
Given Rx for TB but does not respond to anti-tuberculosis treatment.
Aggravating his health more he develops both pericardial effusion and progressive lymphadenopathy.
Large lymphoma cells were evident in the pericardial effusion,
After initially testing negative for AFB and Mycobacterium tuberculosis complex, the patient in this case report was later definitively diagnosed as having tuberculous lymphadenitis by typical pathologic features, identification of AFB, and positive PCR for Mycobacterium tuberculosis complex. Similarly and slightly more than 5 months later, he was diagnosed as having large lymphoma cells in the pericardial effusion, after no sign of lymphoma cells was detected in two previous lymph node samples. The second lymph node biopsy was reviewed and undiagnosed ALK+ ALCL was discovered. This may have been due to irregular pink areas of large lymphoma cells that were overlooked by the pathologist who originally made the diagnosis of “granulomatous lymphadenitis, suggestive of TB, but negative for AFB.”
Check out how interesting the case is, and how tuberculosis and lymphoma hare common features-