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July 19, 2010

Pathology Quiz Case 1: Diagnosis

Author Affiliations
 

JULIA C.IEZZONIMD

Arch Otolaryngol Head Neck Surg. 2010;136(7):746-747. doi:10.1001/archoto.2010.85-b

Diagnosis: Nasopharyngeal tuberculosis

Tuberculosis in the head and neck region is often diagnosed, and several presentations of head and neck tuberculosis have been described. However, solitary nasopharyngeal tuberculosis is an uncommon entity and, to our knowledge, has rarely been reported in the literature. A 10-year retrospective study among 1315 tuberculosis cases in Bradford, England, resulted in 128 patients with head and neck tuberculosis.1Most of these patients (n = 111 [87%]) had cervical tuberculous lymphadenitis. Only 1 patient (a 36-year-old Asian man) presented with bilateral middle ear effusions and was diagnosed as having nasopharyngeal tuberculosis after nasal biopsy. Eighty-nine percent of the patients (n = 114) were of Asian origin, and 10.2% (n = 13) were white. Nalini and Vinayak2described 117 patients with head and neck tuberculosis, 111 of whom (95%) were diagnosed as having cervical lymphadenopathy. They also reported cases of tuberculosis of the larynx, oropharynx, cervical spine, and ear. Nasopharyngeal tuberculosis was not reported.

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