A GRANULOMATOUS abscess of the tongue as the presenting feature of pulmonary tuberculosis is very unusual, with only a few cases having been reported in the literature.1-4 We report such a case.
Report of a Case
Approximately July 1, 1974, a 54-year-old man noted a painful ulcerating lesion on the tip of his tongue. Over the next four weeks the lesion enlarged, and he sought medical attention. His private physician prescribed an oral medication for one week. The lesion continued to progress and on July 8, his physician referred him to the Augusta Veterans Administration (VA) Hospital with an admitting diagnosis of carcinoma of the tongue. The lesion measured 3×2 cm. It had an ulcerating appearance, with surrounding erythema. Routine culture of the lesion yielded α-hemolytic Streptococcus only. A biopsy specimen showed an "intense granulomatous process with tuberculoid reaction, Langhans giant cells, and epithelioid cells," with the final diagnosis
Weaver RA. Tuberculosis of the Tongue. JAMA. 1976;235(22):2418. doi:10.1001/jama.1976.03260480038031