Association of multifocal Hodgkin's lymphoma and tuberculosis infection: A challenging entity

Abstract

The association of Hodgkin's lymphoma and Tuberculosis is a rare entity, resulting in misdiagnose or delay in diagnosis of both diseases, since they share similar signs and symptoms, laboratory tests results and imaging procedures. We report the case of a 63 years old man who consulted for a clinical presentation of pulmonary and cervico-thoracic lymph nodes tuberculosis confirmed at the histopathological examination. The evolution after 5 months of antituberculous treatment was marked by the increase in size of the cervical nodes with a papular skin rash, diffuse abdominal pain and more weight loss. The FDG-PET-scan showed multiple confluent hypermetabolic lymphadenopathies on the whole upper body with cervical skin extension, next to hypermetabolic splenomegaly and focal liver hypermetabolism; next to a bilateral pleural effusion. The histopathological examination of the cervical lymph node specimen concluded to a Hodgkin lymphoma classified as Ann Arbor stage III. The chemotherapy protocol was started, while completing his antituberculous treatment. The patient passed away a few weeks later due to a septic shock. We present this case to supplement the rare literature data concerning the association of Hodgkin's lymphoma and Tuberculosis, defining how they impact the prognosis of one another, in order to comfort the importance of tuberculosis screening in lymphoma patients, especially in endemic areas.

Acute liver failure caused by lymphocyte-depleted Hodgkin lymphoma in tuberculosis and HIV-infected patient

“… 14 This association may sometimes be a nightmare as it may delay diagnosing each other. 15 - 17 In HL, the suppression of cell-mediated immunity may play a role in concomitant reactivation or infection of tuberculosis. 14 , 15 To the best of our knowledge, we could not find an association between lymphocyte-depleted Hodgkin lymphoma and tuberculosis, especially in the liver and spleen.…”

Concomitant Hodgkin’s Lymphoma in a Patient with Tuberculous Spondylitis

“…The coexistence of Hodgkin’s Lymphoma and tuberculosis is a rare entity which may delay the diagnosis and treatment of either of the diseases. [ 6 ] The diagnostic dilemma between Hodgkin’s lymphoma and tuberculosis lies in the similarities in clinical course and findings from imaging studies. Nevertheless, when there is a strong clinical suspicion of tuberculosis, molecular identification and detection of mycobacteria should be performed for accurate diagnosis.…”