Yiğit Ozgür, Cinar Uğur, Uslu Coşkun Berna, Başak Tülay
Department of Otolarynglogy, Sişli Etfal Training Hospital, Istanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2004;13(3-4):98-101.
A 33-year-old male patient was admitted to our hospital with a painless ulcer on the tongue. The lesion was 2 x 3 cm in size, necrotic, and whitish in the anterior part of the ventral surface of the tongue. On further investigation, pulmonary tuberculosis was diagnosed. Cultures of the biopsy specimen and the sputum revealed acid fast bacilli. Histopathologic examination of the biopsy specimen showed tubercles consisting of epithelioid granulomas with caseous necrosis and Langhans giant cells. The lesion was thought to be an extrapulmonary manifestation of pulmonary tuberculosis. Antituberculous therapy was initiated and the ulcer regressed after two months. In the differential diagnosis of nonhealing oral ulcers, tuberculosis should also be considered, especially in patients living in a high risk country for tuberculosis.
一名33岁男性患者因舌部无痛性溃疡入院。病变大小为2×3厘米，位于舌腹前部，呈坏死性、白色。进一步检查后，诊断为肺结核。活检标本和痰液培养显示抗酸杆菌。活检标本的组织病理学检查显示结核结节，由上皮样肉芽肿、干酪样坏死和朗汉斯巨细胞组成。该病变被认为是肺结核的肺外表现。开始抗结核治疗，两个月后溃疡消退。在不愈合口腔溃疡的鉴别诊断中，也应考虑结核病，尤其是生活在结核病高风险国家的患者。
