Primary Nasopharyngeal Tuberculosis: A Case Report Focused on Nasopharyngoscopic Features and CT Findings

Min, Hyun Jin; Kim, Kyung Soo

doi:10.1177/0145561320931951

Cited by 11 publications

(18 citation statements)

References 11 publications

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“…e most important differential diagnosis in the present case was nasopharyngeal carcinoma, in addition to various diseases such as fungal infection (aspergillosis and mucormycosis), granulomatous inflammation (sarcoidosis, leprosy, syphilis, and midline lethal granuloma), and autoimmune disease (polyarteritis nodosa, eosinophilic granulomatosis with polyangitis, and granulomatosis with polyangitis) [4]. In the present case, the ulcerative mass covered with a thick yellowish discharge was typical of nasopharyngeal TB [2,8].…”

Section: Discussionmentioning

confidence: 52%

“…TB infection is still one of the deadliest communicable diseases noted globally, with an estimated 10.0 million people acquiring the disease in 2019 [3]. Extrapulmonary TB accounts for 15% of all newly diagnosed TB cases worldwide, of which 10%-35% manifest in the head and neck region [4]. e most common head and neck TB sites are cervical lymph nodes (87.9%) and larynx (8.7%), but the involvement of other head and neck regions is rare (3.4%) [5].…”

Section: Discussionmentioning

confidence: 99%

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A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base

Matsuo

Tanaka

Sakata

et al. 2021

Case Reports in Otolaryngology

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Primary nasopharyngeal mycobacteriosis is a rare disease. We present a case in which skull base bone erosion appeared and was alleviated during the course of the treatment. Bone complications occur in osteoarticular mycobacteriosis, but their occurrence in primary nasopharyngeal mycobacteriosis has not been reported. A 77-year-old immunocompromised Asian woman presented with a right occipitotemporal headache. An ulcerative mass covered with a thick yellowish discharge was found in the roof and posterior walls of the right nasopharynx. Because histopathological examination indicated the presence of mycobacterial infection, we began using antituberculosis medication for the treatment because of the possibility of primary nasopharyngeal tuberculosis. However, this was followed by glossopharyngeal and vagus nerve paralysis. Computed tomography (CT) showed a diffuse enhancing mucosal irregularity in the nasopharynx with bony erosion of the external skull base. Deep tissue biopsy was repeated to differentiate it from malignant lesions, and drainage of pus from the right nasopharynx was confirmed. Subsequently, the headache, neurological findings, and the yellowish discharge disappeared, and the bony erosion of the external skull base was alleviated. Surgical intervention should also be considered for drug-resistant mycobacteriosis. We concluded that mycobacteriosis should also be considered apart from carcinoma even if CT shows a diffuse enhancing mucosal irregularity with bone destruction in the nasopharynx.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base

Matsuo

Tanaka

Sakata

et al. 2021

Case Reports in Otolaryngology

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“…Although primary nasopharyngeal tuberculosis is very rare, it is seen in countries where tuberculosis infection is endemic. 12–14 In their case report, Patil et al 15 mentioned a patient presenting with bilateral nasal discharge and obstruction, which are rarely seen symptoms of nasopharyngeal tuberculosis. These patients may also present with sore throat, nosebleeds, cough, weight loss, fever, and malaise.…”

Section: Discussionmentioning

confidence: 99%

Lesions that mimic malignant tumors in nasopharyngeal biopsies: case series of 10 years

Özşen

Saraydaroğlu

Yirmibes

et al. 2021

Tumori

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Introduction: Lesions mimicking malignancies in the nasopharynx are frequently seen in adult patients. These include inflammatory, metaplastic, and cystic lesions. We aimed to draw attention to rare tumor-like lesions that can be confused with malignancies and cause diagnostic difficulties clinically and radiologically. Methods: A total of 538 patients who underwent nasopharyngeal biopsy in our center between January 2010 and June 2020 were evaluated. Patient information was obtained from patient files and evaluated retrospectively. Results: A total of 19 of the 538 patients had tumor-like lesions that were included in the study. Granulomatous inflammation was present in seven cases, oncocytic metaplasia in four cases, benign cyst in five cases, fungal infection in two cases, and immunoglobulin G4–related disease in one case. Conclusions: The nasopharynx is a region where various lesions can be seen. Some lesions form tumor-mimicking mass effect, cause increased thickness, and lead to increased metabolic activity in positron emission tomography–computed tomography that create the illusion of a malignant tumor and histopathologic verification is crucial. We aimed to present these rare tumor-like lesions that should be kept in mind in the differential diagnosis.

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“… 2 Nasopharyngeal tuberculosis may be either primary or secondary to pulmonary tuberculosis. Although there are few reported cases of primary nasopharyngeal tuberculosis, 2 – 6 nasopharyngeal tuberculosis usually occurs secondary to pulmonary tuberculosis as a result of upper respiratory tract contact with the lung secretions. 6 Primary nasopharyngeal tuberculosis is described as an isolated infection of the nasopharynx in the absence of pulmonary or systemic disease.…”

Section: Introductionmentioning

confidence: 99%

“…Initial symptoms of nasal and nasopharyngeal tuberculosis are nonspecific, which makes early diagnosis challenging. 3 Nasopharyngeal tuberculosis with cervical lymph node can be confused with a cervical malignant disease 8 and can mimic nasopharyngeal carcinoma (NPC). 9 …”

Section: Introductionmentioning

confidence: 99%

Diagnostic dilemma in a patient with nasopharyngeal tuberculosis: A case report and literature review

Penjor

Pradhan²

2022

SAGE Open Medical Case Reports

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Tuberculosis remains a major cause of morbidity and mortality globally, with a global total of about 10 million people falling ill with it in 2020. Until the coronavirus (COVID-19) pandemic, tuberculosis was the leading cause of death from a single infectious agent. Nasopharyngeal tuberculosis is a rare type of extrapulmonary tuberculosis that may be either primary or secondary to pulmonary tuberculosis. Nasopharyngeal tuberculosis may be mistaken for nasopharyngeal carcinoma as both conditions may present with a nasopharyngeal mass and cervical lymph node enlargement. We present a case of nasopharyngeal tuberculosis secondary to pulmonary tuberculosis who presented without any nasal or respiratory symptoms. The patient presented with a cervical lymph node enlargement and a nasopharyngeal mass was detected on nasal endoscopy. Fine needle cytology from the cervical node and the initial biopsy report from the nasopharyngeal mass were not confirmatory, causing a diagnostic dilemma. A repeat biopsy from the nasopharyngeal mass with the demonstration of caseating granuloma and acid-fast bacilli in the specimen pointed to the diagnosis of nasopharyngeal tuberculosis. The patient responded well to the standard 6-month anti-tubercular regimen. Nasopharyngeal tuberculosis may mimic nasopharyngeal carcinoma and a repeat biopsy may be necessary to confirm the diagnosis.

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Primary Nasopharyngeal Tuberculosis: A Case Report Focused on Nasopharyngoscopic Features and CT Findings

Cited by 11 publications

References 11 publications

A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base

A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base

Lesions that mimic malignant tumors in nasopharyngeal biopsies: case series of 10 years

Diagnostic dilemma in a patient with nasopharyngeal tuberculosis: A case report and literature review

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