Tuberculous Cervical Lymphadenitis Masquerding as Metastatis From Papillary Thyroid Carcinoma

Abstract

Clinically apparent cervical lymphadenopathy has been found at the initial presentation in 23 to 56 % of cases of papillary thyroid carcinoma. Here we report tuberculous lymphadenitis mimicking metastatic lymph nodes from papillary thyroid carcinoma and suggest that tuberculosis apart from metastasis in papillary thyroid carcinoma should also be considered in the etiology of enlarged lymph nodes in such patients, especially in those with risk factors for tuberculosis. Therefore, the importance of careful pre-operative evaluation of cervical lymph node metastasis cannot be overestimated, so that patients do not undergo unnecessary neck dissection for other benign conditions.

Interesting association of squamous cell carcinoma of soft palate and tuberculous lymphadenitis

“…3 PET/CT scan revealed higher FDG uptake in the uvula and soft palate (SUV max : 12) and in the right neck (level II, III, IV) (SUV max : 11.7) and there was also higher FDG uptake (SUV max : 5.4) in the left supraclavicular region Eur Arch Otorhinolaryngol histopathological evaluation of the level III and supraclavicular lymph nodes on the left, TB. This case demonstrates that similarities in the clinical and radiological presentations of TB and malignancy and the not uncommon involvement of extrapulmonary sites and lymph nodes by TB can lead to an incorrect diagnosis [6,12]. Among the lymph nodes in the head and neck, the supraclavicular lymph nodes are the most frequently involved by TB [6].…”

“…There are reports of a relationship between TB and lung cancer, head and neck cancers, lymphoma, and other types of cancer [2,6,9,10] but the relationship may also be coincidental. Moreover, SCC may develop against a background of a previous Mtb infection or it could mimic Mtb infection [2,8,9].…”

“…These data highlight the need for a thorough clinical examination and biopsy of the head and neck in patients in whom SCC of these regions is suspected. If the diagnosis of SCC is confirmed, either clinically or based on combined clinical and contrast-enhanced computed tomography (CT) findings, then magnetic resonance imaging (MRI) and a positron emission tomography/ computed tomography (PET/CT) scan should be performed to evaluate the aerodigestive tract [4,6,7].…”

Unexpected Finding in the Neck Dissection Specimen of Papillary Thyroid Carcinoma: Concurrence of Metastatic Deposits and Tuberculosis: Case Report

“…Should any suspicion arise in this regard, excisional biopsy of lymph nodes must be carried out as a part of neck dissection operation. 5 We did not suspect of tuberculosis prior to the operation, but the patient was diagnosed after neck dissection simultaneously performed with total thyroidectomy.…”

“…In the event of metastatic cervical lymph nodes, on the other hand, the treatment of choice is a neck dissection, and therefore it is vital to perform an accurate examination of lymph nodes in patients with papillary thyroid carcinomas. 5 In conclusion, as tuberculosis of cervical lymph nodes may manifest as malignant tumor foci, the possibility of simultaneous and/or competing diagnoses of tuberculosis and metastasis should always be kept in mind in suspicious cases. …”