Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass
An 80-year-old woman presented with dysphagia, odynophagia and progressive weight loss. Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous...
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| creator | Pratt, Sarah Henderson, Arthur Gillett, Stuart |
| description | An 80-year-old woman presented with dysphagia, odynophagia and progressive weight loss. Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous necrosis. Acid-fast bacilli were identified on Ziehl-Neelsen stain and the appearances were consistent with Mycobacterium bovis. Closer inspection of the patient’s medical history revealed that she had previously undergone right hemicolectomy for an ascending colon stricture. The histology had shown granulomatous inflammation consistent with intestinal tuberculosis but no systemic treatment had been instigated at the time. This case highlights the importance of taking a detailed clinical history as well as the need to be cognisant of tuberculosis masquerading as cancer in the head and neck. |
| doi_str_mv | 10.1136/bcr-2018-225436 |
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Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous necrosis. Acid-fast bacilli were identified on Ziehl-Neelsen stain and the appearances were consistent with Mycobacterium bovis. Closer inspection of the patient’s medical history revealed that she had previously undergone right hemicolectomy for an ascending colon stricture. The histology had shown granulomatous inflammation consistent with intestinal tuberculosis but no systemic treatment had been instigated at the time. This case highlights the importance of taking a detailed clinical history as well as the need to be cognisant of tuberculosis masquerading as cancer in the head and neck.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2018-225436</identifier><identifier>PMID: 30323101</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Aged, 80 and over ; Biopsy ; Cancer ; Carcinoma, Squamous Cell - diagnosis ; Case reports ; Dairy products ; Deglutition Disorders - etiology ; Dysphagia ; Ears & hearing ; Family medical history ; Female ; Head and Neck Neoplasms - diagnosis ; Hepatitis ; Histology ; Humans ; Infections ; Investigations ; Mycobacterium bovis - isolation & purification ; Rare Disease ; Rheumatoid arthritis ; Squamous cell carcinoma ; Tuberculosis ; Tuberculosis, Oral - diagnosis ; Tuberculosis, Oral - microbiology ; Tuberculosis, Oral - pathology ; Zoonoses</subject><ispartof>BMJ case reports, 2018-10, Vol.2018, p.bcr-2018-225436</ispartof><rights>BMJ Publishing Group Limited 2018. 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Published by BMJ. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3716-5aa85bc9308c8af79205cc44cf53e0d9708c68372e621c075bfccbf9d1202a163</citedby><cites>FETCH-LOGICAL-b3716-5aa85bc9308c8af79205cc44cf53e0d9708c68372e621c075bfccbf9d1202a163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194383/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194383/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30323101$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pratt, Sarah</creatorcontrib><creatorcontrib>Henderson, Arthur</creatorcontrib><creatorcontrib>Gillett, Stuart</creatorcontrib><title>Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>An 80-year-old woman presented with dysphagia, odynophagia and progressive weight loss. Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous necrosis. Acid-fast bacilli were identified on Ziehl-Neelsen stain and the appearances were consistent with Mycobacterium bovis. Closer inspection of the patient’s medical history revealed that she had previously undergone right hemicolectomy for an ascending colon stricture. The histology had shown granulomatous inflammation consistent with intestinal tuberculosis but no systemic treatment had been instigated at the time. This case highlights the importance of taking a detailed clinical history as well as the need to be cognisant of tuberculosis masquerading as cancer in the head and neck.</description><subject>Aged, 80 and over</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Carcinoma, Squamous Cell - diagnosis</subject><subject>Case reports</subject><subject>Dairy products</subject><subject>Deglutition Disorders - etiology</subject><subject>Dysphagia</subject><subject>Ears & hearing</subject><subject>Family medical history</subject><subject>Female</subject><subject>Head and Neck Neoplasms - diagnosis</subject><subject>Hepatitis</subject><subject>Histology</subject><subject>Humans</subject><subject>Infections</subject><subject>Investigations</subject><subject>Mycobacterium bovis - isolation & purification</subject><subject>Rare Disease</subject><subject>Rheumatoid arthritis</subject><subject>Squamous cell carcinoma</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Oral - diagnosis</subject><subject>Tuberculosis, Oral - microbiology</subject><subject>Tuberculosis, Oral - pathology</subject><subject>Zoonoses</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU1rGzEQhkVJaELic29F0EsIbK2P1Wr3Egj5aAsOuaTgm5BkrSuzu3I0q4D_feXYNUkv0WXEzDPvzPAi9IWS75TyampsLBihdcGYKHn1CZ1SKWQhGzI_evM_QROAFcmP07Iu-Wd0wglnnBJ6iua3HsD1ftCjW-AxGRdt6gJ4wFYnyDmzwQ8bG4y2o4s-9diEl1xdRwduGP2wxBqwxmMYlslho8HhXgOco-NWd-Am-3iGft_fPd38LGaPP37dXM8KwyWtCqF1LYxtOKltrVvZMCKsLUvbCu7IopE5X9VcMlcxaokUprXWtM2CMsI0rfgZutrprpPp3cLmnaLu1Dr6XseNCtqr95XB_1HL8KIq2pS85lngYi8Qw3NyMKreg3VdpwcXEiiWJ0nBpdjO-vYfugopDvm8V4pImcFMTXeUjQEguvawDCVqa5zKxqmtcWpnXO74-vaGA__Ppgxc7gDTrz5U-wulkaHV</recordid><startdate>20181014</startdate><enddate>20181014</enddate><creator>Pratt, Sarah</creator><creator>Henderson, Arthur</creator><creator>Gillett, Stuart</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20181014</creationdate><title>Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass</title><author>Pratt, Sarah ; 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Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous necrosis. Acid-fast bacilli were identified on Ziehl-Neelsen stain and the appearances were consistent with Mycobacterium bovis. Closer inspection of the patient’s medical history revealed that she had previously undergone right hemicolectomy for an ascending colon stricture. The histology had shown granulomatous inflammation consistent with intestinal tuberculosis but no systemic treatment had been instigated at the time. This case highlights the importance of taking a detailed clinical history as well as the need to be cognisant of tuberculosis masquerading as cancer in the head and neck.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30323101</pmid><doi>10.1136/bcr-2018-225436</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged, 80 and over Biopsy Cancer Carcinoma, Squamous Cell - diagnosis Case reports Dairy products Deglutition Disorders - etiology Dysphagia Ears & hearing Family medical history Female Head and Neck Neoplasms - diagnosis Hepatitis Histology Humans Infections Investigations Mycobacterium bovis - isolation & purification Rare Disease Rheumatoid arthritis Squamous cell carcinoma Tuberculosis Tuberculosis, Oral - diagnosis Tuberculosis, Oral - microbiology Tuberculosis, Oral - pathology Zoonoses |
| title | Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass |
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