Reddy Ramanjula C, Mathew Meghena, Parameswaran Ashok, Narasimhan R
Department of Respiratory Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India.
Department of Pathology, Apollo Hospitals, Chennai, Tamil Nadu, India.
Lung India. 2014 Jan;31(1):59-62. doi: 10.4103/0970-2113.125985.
Tuberculosis (TB) presenting with Hodgkin's Lymphoma is a rare and difficult clinical situation for any physician to identify and to manage because of very similar clinical presentation. Herein we report a case of 29 year old woman who presented with enlarged lymph nodes, diagnosed and initiated on therapy for TB, based on the cervical node biopsy that showed granulomatous lymphadenitis suggestive of TB. Despite being on regular isoniazid, rifampicin, pyrazinamide and ethambutol regimen, she did not improve but worsened clinically! After an extensive work up that included endobronchial ultrasound (EBUS) and mediastinoscopy, a diagnosis of Hodgkin's disease of nodular sclerosis type was made. She was treated with chemotherapy and radiotherapy along with her TB therapy. Patient showed significant improvement following therapy.
对于任何医生来说,结核合并霍奇金淋巴瘤都是一种罕见且棘手的临床情况,因为其临床表现非常相似,难以识别和处理。在此,我们报告一例29岁女性病例,该患者出现淋巴结肿大,根据颈部淋巴结活检显示提示结核的肉芽肿性淋巴结炎,诊断为结核病并开始治疗。尽管规律服用异烟肼、利福平、吡嗪酰胺和乙胺丁醇,但她病情并未改善,反而临床症状加重!经过包括支气管内超声(EBUS)和纵隔镜检查在内的全面检查后,确诊为结节硬化型霍奇金病。她在接受结核病治疗的同时接受了化疗和放疗。治疗后患者病情显著改善。