Pathology

Biography

Biography: Sujata Jetley

Abstract

Tuberculosis is a major cause of morbidity and mortality in the developing world and remains a leading public health problem worldwide. It is known to coexist with various disease processes and an awareness of unusual clinical presentations mimicking diverse conditions, as seen in this series, highlight the importance of a high index of suspicion in the timely diagnosis of tuberculosis. Case 1: Fever with axillary lymphadenopathy, clinical impression: Tuberculosis. Final diagnosis: Coexistent axillary hydatid disease and tuberculosis. Case 2: Fever with nodular erythematous rashes, clinical impression: Hansen’s disease. Final diagnosis: Coexistent Erythema Nodosum Leprosum and tubercular lymphadenitis. Case 3: Irregular growth cervix, bleeds on touch, clinical impression: Carcinoma cervix. Finaldiagnosis: Tuberculosis cervix. Case 4: Tenderness & swelling left breast, 15 days duration, clinical impression: Breast abscessFinal diagnosis: Tuberculosis breast. Case 5: Hoarseness of voice 2 years duration, clinical impression: Carcinoma larynx. Final diagnosis: Spindle cell carcinoma larynx with tubercular lymphadenitis. All cases demonstrated characteristic epithelioid cell granulomas with or without necrosis along with ZiehlNeelson staining and culture positivity except case 5 which was negative and molecular techniques were used for diagnosis. All patients were placed on anti-tubercular treatment with good response on regular follow up. Tuberculosis, today, is a re-emerging disease with a changing epidemiology. Evidence of systemic or lung involvement is not always present. Laboratory findings and radiological findings play an important role in the evaluation. Definitive tissue diagnosis along with demonstration of AFB and isolation in cultures or by molecular techniques remains the gold standard.