A patient presenting with generalised lympadenopathy - sarcoidosis, lymphoma or tuberculosis?

Petousi, Nayia; Mathew, Jovin John; Thomas, Enson

doi:10.1136/bcr.11.2011.5150

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…According to the WHO, the use of Xpert/Ultra is endorsed in people with suspected ETB and those living with HIV because both diagnoses are extremely challenging. On the other hand, five cases presented with both ETB and lymphoma, which could be quite similar in clinical presentation and radiological findings, a fact that has been reported to hinder the final diagnosis 8 . Other prevalent factors were chronic renal disease in three patients and diabetes in two patients, both of which are associated with ETB 9 .…”

Section: Discussionmentioning

confidence: 70%

Performance of Real-Time Semi-Quantitative Polymerase Chain Reaction Assay for Optimum Diagnosis of Extrapulmonary Tuberculosis and Sensitivity to Rifampin in a Tertiary Care Center

Peñata-Bedoya¹,

Zuluaga-Avendaño²,

Castaño-Sepúlveda³

et al. 2021

RIC

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Background: Tuberculosis represents a public health problem, with extrapulmonary disease occurring in 15% of incident cases annually. Early diagnosis is a challenge due to its paucibacillary nature. Recently, a molecular real-time semi-quantitative assay (GeneXpert Ultra) was developed to overcome limitations of the previous assay version (Xpert MTB/RF). Objective: The objective of the study was to assess the usefulness of the novel next-generation GeneXpert assay in extrapulmonary samples from different anatomic sites under routine diagnostic conditions at a university medical center. Methods: A total of 519 samples from patients with presumptive diagnosis of extrapulmonary TB were subjected to smear microscopy, culture, and molecular assay. Univariate analyses for demographic and microbiological characteristics were performed. The sensitivity, specificity, and Kappa index with a 95% confidence interval were determined. Results: Molecular assay was positive in 53 samples (10.2%), of which 38 (71.6%) belonged to the "low" and "trace" semi-quantitative categories. The overall sensitivity and specificity were 86.4% (95% confidence intervals [CI]: 74.1-98.8) and 95.6% (95% CI: 93.7-97.6), respectively. Phenotypic drug susceptibility testing for rifampin was 100% concordant. Conclusions: Molecular assay showed significant results when compared to other standard tests, making it a useful tool that could lead in the improvement to a rapid diagnosis of extrapulmonary disease.

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Section: Discussionmentioning

confidence: 70%

Performance of Real-Time Semi-Quantitative Polymerase Chain Reaction Assay for Optimum Diagnosis of Extrapulmonary Tuberculosis and Sensitivity to Rifampin in a Tertiary Care Center

Peñata-Bedoya¹,

Zuluaga-Avendaño²,

Castaño-Sepúlveda³

et al. 2021

RIC

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“…La TBC y el linfoma tienen varias características clínicas en común, como baja de peso, fiebre, diaforesis nocturna y poliadenopatías 1 .…”

Section: Discussionunclassified

Granulomas pulmonares y en médula ósea: más allá de la tuberculosis. A propósito de un caso

2017

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The differential diagnosis of pulmonary tuberculosis and lymphoma with pulmonary infiltration is very difficult, given their similar clinical characteristics. We report a 59 year old female with weight loss, fever, dyspnea and cough of several months of duration. She had a cavitated mass in lung imaging. A positive conventional PCR lead to the diagnosis of tuberculosis, but she had negative smears and cultures for Mycobacterium tuberculosis. The patient did not respond to treatment and her clinical condition worsened. A peripheral lymph node biopsy confirmed the presence of a diffuse large B cell non-Hodgkin lymphoma. Bone marrow pathology showed non caseating granulomas, again with negative microbiological tests for M. tuberculosis. Findings in the bone marrow were interpreted as a secondary sarcoid reaction to cancer and PCR results as a false positive. The lymphoma was treated, achieving complete remission. This case highlights the importance of the differential diagnosis between these two entities.

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“…Extrapulmonary TB and lymphoma could be quite similar in clinical presentation, and radiological findings and have been reported to cause difficulty in diagnosis. [ 1 2 ] Non-Hodgkin lymphoma (NHL) is heterogeneous in presentation, course and prognosis. Based on the characteristics of the disease at the time of presentation and patients’ life expectancy, NHL is divided into indolent and aggressive groups.…”

Section: Discussionmentioning

confidence: 99%

“…Quite often, it poses diagnostic difficulty because of clinical presentation and radiological findings similar to those in other conditions like lymphoma and sarcoidosis. [ 1 ] Histopathological and microbiological confirmation, though the gold standard for diagnosis of extrapulmonary TB has certain limitations. Quite often, there are problems of negative yield, technical difficulty in accessing the involved organ, risks inherent to invasive procedures, etc., It is not uncommon for a primary care physician to start anti-tubercular treatment on clinical suspicion supported by radiological findings, without establishing a tissue diagnosis.…”

Section: Introductionmentioning

confidence: 99%

T-cell lymphoma masquerading as extrapulmonary tuberculosis: case report and review of literature

Ranjan

Dutta

Kakkar

et al. 2015

J Family Med Prim Care

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It is often difficult to establish confirmatory diagnosis in cases of extrapulmonary tuberculosis (TB) because of its paucibacillary nature and difficulty in accessing the involved organs. In several cases, empirical anti-tubercular treatment is started, and the patient is followed-up closely for response. In countries with high prevalence of TB, it is a reasonably good strategy and works most of the times. However, catastrophe may occur when aggressive lymphomas masquerade as TB.

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A patient presenting with generalised lympadenopathy - sarcoidosis, lymphoma or tuberculosis?

Cited by 11 publications

References 14 publications

Performance of Real-Time Semi-Quantitative Polymerase Chain Reaction Assay for Optimum Diagnosis of Extrapulmonary Tuberculosis and Sensitivity to Rifampin in a Tertiary Care Center

Performance of Real-Time Semi-Quantitative Polymerase Chain Reaction Assay for Optimum Diagnosis of Extrapulmonary Tuberculosis and Sensitivity to Rifampin in a Tertiary Care Center

Granulomas pulmonares y en médula ósea: más allá de la tuberculosis. A propósito de un caso

T-cell lymphoma masquerading as extrapulmonary tuberculosis: case report and review of literature

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