Tuberculosis of the Base of the Tongue: A Rare Case Report
Z. Elkrimi
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
C. Rsaissi *
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
W. Bijou
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Y. Oukessou
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
R. Abada
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
S. Rouadi
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
M. Roubal
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
M. Mahtar
ENT Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
It is estimated that up to 20% of TB cases involve extrapulmonary organs [1]. In the field of otolaryngology, cervical lymphadenitis is the most common disease, accounting for 95% of otolaryngology cases. All other sites, such as the larynx, nasal passages, nasopharynx, pharynx, tonsils, ears, mastoids, or salivary glands each account for less than 1% of all cases [2]. Cases limited to the oropharynx are particularly rare, with the palatine tonsils affected in 45% of cases. The posterior pharyngeal wall, tonsillar columns, lateral walls, soft palate, and tongue are the least likely sites [3].
We report a rare case of extrapulmonary tuberculosis localized at the base of the tongue, discovered incidentally on pet scan of a 61 year old female, that revealed a right hypermetabolic focus at the base of the tongue. The laryngoendoscopy was performed, which was normal, and several deep biopsies were taken. The histopathological exam found a necrotizing tuberculoid inflammatory granulomatous
Extrapulmonary tuberculosis (EPTB) has multiple causes and has become an increasingly important part of TB morbidity during the 20th century. EPTB is evaluated under two specific conditions; when inspecting unexplained fever and biopsy showing granulomatous inflammation of an organ or site of infection [4].
Keywords: Tuberculosis, base of the tongue, treatment, extrapulmonary tuberculosis
How to Cite
Downloads
References
Yang Z, Kong Y, Wilson F, Foxman B, Fowler AH, Marrs C, et al. Identification of risk factors for extrapulmonary tuberculosis. Clin Infect Dis. 2004;38 (2):199-205.
Nalini B, Vinayak S. Tuberculosis in ear, nose, and throat practice: Its presentation and diagnosis. Am J Otolaryngl. 2006; 27(1):39-45.
Moulonguet l, Delguidice P, Chauvin Jl. Tuberculous angina. about a case in Senegal. Ann Otolaryngol Chir Cervicofac. 1995;112(1–2):78-9.
Iseman MD. Extrapulmonary tuberculosis in adults. in: Iseman md, editor. a clinician’s guide to tuberculosis. Philadelphia: Lippincott williams & wilkins. 2000;145-97.
Hathiram BT, Grewal DS, Irani DK, Tankwal PM, Patankar M. Tuberculosis of the cheek: A case report. Primary lingual tuberculosis: A case report. J Laryngeal Vet. 1997;111:872-3.
Soni NK, Chatterjee P, Nahata Sk. Tuberculosis of the tongue. Ind. 1980;28 (1):22-5.
Miziara ID. Tuberculosis affecting the oral cavity in Brazilian hiv-infected patients. Oral surg oral med oral pathol oral radiol endod. 2005;100:179-182.
Popescu MR, Călin G, Strâmbu I, Olaru M, Bălăşoiu M, Huplea V, Zdrancotă C, Pleşea RM, Enache SD, Pleşea IE. Lymph node tuberculosis – An attempted clinico-morphological study and review of the literature. Rom J Embryo Morphol. 2014;55 (2 suppl):553-567.
Nemes RM, Lanosies Popcs et al. Tuberculosis of the oral cavity. Rom J Embryo Morphol. 2015;56(2):521-25.
Ucinska R, Sieminska A, Stominski JM. Tuberculosis of the tongue. Case Rep. Clin Pract Rev. 2002;3:102-04.
Kilgore TR, Jenkins DW. Laryngeal Tuberculosis. Chest. 1983;83:139-41.
Dimitrokopoulus I, Rouloumis L, Lazandis N, Caracosis D, Trigondis G, Sichlendis L. Primary tuberculosis of the oral cavity. Oral Surg Oral Med Oral Pathol. 1991;72(6): 712-15.
Persimmon Ok, Catch As, Persimmon Ik, Rafailidis Pi, Falagas Me. Tuberculosis of the oral cavity: A systematic review. Eur J Oral Sci. 2010;118(2):103-9.
Eng HL, Lu SY, Yang CH, Chen WJ. Oral tuberculosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(4):415-20.
Bhandarker PD, Kasbekar VG, Shah RP, Hakim PP. Primary tuberculous ulcer of the tongue; A case report. Tropical Doctor. 1993;23:41–2.
Flour S, Flour B, Bayal I, Face C, Yaldiz E, Bulum S, Karagoz T. Secondary lingual tuberculosis: A case report. Turkish Respir J. 2003;4:25-26.
Cornet H, Scnaefer RF, Mahoney PL. Bilateral tuberculous granulomas of the tongue. the otolarynical arch. 1965;82:649-51. figure 2: a) x40, h&e, ulceration of the squamous epithelium, with a dense lymphocytic infiltration around the granuloma structures under the epithelium. b) x100, h&e, including giant cell granulomatous structure. eur j gen med 2017;14(3):73-7.
Dogra Ss, Chander B, Krishna M. tuberculosis of the oral cavity: a series of one primary and three secondary cases. indian j otolaryng head neck surg. 2013;65 (3):275-79.
Held T, Kissler W, Reich Let A, Mielke M, Alexander M. Tuberculosis of the larynx oral cavity and pharynx. Dithsch with. Wocherscher. 1991;116(31-32):1186-90.
Centers for disease control prevention. Treatment of tuberculosis, american thoracic society, cdc, and infectious diseases society of america. Mmwr. 2003; 52:1–15. (no. rr-11)
Jawad J, El-zuebi F. Primary lingual tuberculosis: A case report. journal of laryngology and otology. 1996;110(2): 177-8.