Tuberculous ulcer of the tongue: a case report.

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.