Museedi Omar, Hameedi Ameer, Al-Dorbie Ban, Abdullah Bashar
Lecturer, Oral Diagnosis Department, Collage of Dentistry, Baghdad University, Baghdad, Iraq.
Lecturer, Collage of Medicine, Baghdad University, Baghdad, Iraq.
J Oral Maxillofac Surg. 2020 Nov;78(11):1981-1985. doi: 10.1016/j.joms.2020.05.048. Epub 2020 Jun 14.
A diagnosis of tuberculosis (TB) of the head and neck has been a dilemma for clinicians, because the clinical and pathologic features tend to mimic different pathologies. Our study aimed to identify the demographic, clinical, and pathologic features of head and neck TB to help healthcare providers in the early detection of the disease.
We performed a retrospective analysis using the medical archives at the pathology laboratory. Twenty-one patients with a clinical and pathologic diagnosis of head and neck TB were identified from 2010 to 2019.
The age distribution was broad, with 28.5% of the patients younger than 15 years old. Seven patients had oral TB, with the most common sites affected the labial vestibule (3 cases) and buccal vestibule (3 cases), followed by 1 case in the tongue. The predominant clinical presentation was ulceration, and the most common entity in the clinical differential diagnosis was squamous cell carcinoma. The most common histopathologic pattern of oral TB was a noncaseating granuloma. Most of the tuberculous lymphadenitis was located in the submandibular and submental areas.
TB of the head and neck region is not, as previously thought, a rare condition. Head and neck TB, in general, and oral TB, in particular, are great mimickers of different pathologic entities. In particular, the absence of the typical histopathologic pattern of TB granuloma has made the diagnosis more complicated. Healthcare providers must be vigilant and consider all the demographic, clinical, and histopathologic features to detect the disease earlier, because an early diagnosis can result in better outcomes.
头颈部结核病的诊断一直是临床医生面临的难题，因为其临床和病理特征往往与不同的病理情况相似。我们的研究旨在确定头颈部结核病的人口统计学、临床和病理特征，以帮助医疗服务提供者早期发现该疾病。
我们使用病理实验室的医学档案进行了回顾性分析。从2010年至2019年确定了21例临床和病理诊断为头颈部结核病的患者。
年龄分布广泛，28.5%的患者年龄小于15岁。7例患有口腔结核，最常受累的部位是唇前庭（3例）和颊前庭（3例），其次是舌部1例。主要临床表现为溃疡，临床鉴别诊断中最常见的疾病是鳞状细胞癌。口腔结核最常见的组织病理学模式是非干酪样肉芽肿。大多数结核性淋巴结炎位于下颌下和颏下区域。
头颈部结核病并非如先前认为的那样是一种罕见疾病。一般而言，头颈部结核病，尤其是口腔结核，很容易与不同的病理实体相混淆。特别是，缺乏典型的结核肉芽肿组织病理学模式使诊断更加复杂。医疗服务提供者必须保持警惕，考虑所有人口统计学、临床和组织病理学特征以更早地发现该疾病，因为早期诊断可带来更好的结果。
