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Med Klin (Munich). 2006 Jun 15;101(6):500-4.

[Lymph node tuberculosis as primary manifestation of Hodgkin's disease].

[Article in German]

Author information

1
Klinik und Poliklinik für Innere Medizin I, Universität Regensburg, 93042 Regensburg. franz.audebert@klinik.uni-r.de

Abstract

HISTORY AND FINDINGS ON ADMISSION:

A 63-year-old female patient was admitted to the authors' hospital for further diagnostic work-up for suspected reactivation of a previously successfully treated lymph node tuberculosis, which had been diagnosed 1 year prior to the current admission. The clinical signs consisted of worsening of the patient's general condition, negacervical lymphadenopathy, night sweats, dyspnea, and superficial inflammation of the right mamma.

FINDINGS:

A contrast-enhanced CT scan of the neck, thorax and abdomen revealed a generalized enlargement of the cervical, axillar, mediastinal and retroperitoneal lymph nodes, multiple intrapulmonary nodular lesions with a diameter of up to 6 mm, and a substantial right-sided pleural effusion.

COURSE OF DISEASE:

Under the assumption of reactivation of a lymph node tuberculosis, the patient was initially treated with an extended tuberculostatic therapy. Because of disease progression another lymph node biopsy was performed revealing Hodgkin's disease of mixed-cellularity type with a partly histiocytic necrotizing, partly tuberculoid reaction. The biopsy was negative for acid-fast bacilli. Thereupon initiated chemotherapy according to the ABVD protocol led to a rapid amelioration of the clinical symptoms.

CONCLUSION:

In the clinical setting of suspected or confirmed lymph node tuberculosis malignant lymphoma should always be considered. This consideration is particular important since Hodgkin's disease is typically associated with a cellular immunosuppression predisposing the subject to tuberculosis.

PMID:
16767573
DOI:
10.1007/s00063-006-1071-3
[Indexed for MEDLINE]
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