SESSION TITLE: Tuberculosis Case Report Posters
SESSION TYPE: Case Report Poster
PRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PM
PURPOSE: To diagnose and treat an old patient with a rare tongue tumor.
METHODS: A 74 year patient, big smoker (> 60PA), moderate consumer of ethanol, with occupational exposure to silicium (worked in casting 25 years), discovered a year ago with lung lesions on the routine chest x-rays, without respiratory symptoms at that time. Chest x-ray of sept 2012 show confluent and ulcerated opacities on left superior lobe and sputum exam for bK was negative. He was diagnosed with Pneumonia of unspecified etiology. Under antibiotic treatment Rx remained unchanged, and the patient has not continued the investigations. In March 2013, is discovered in the ENT Department with a tumor free straight edge ulcerated of the tongue. In April 2013 underwent to surgical excision of tongue tumor. (about 1.5 cm). Patient start TB treatment on July 2013 with a very good evolution.
RESULTS: CT scan from July 2013 show condensation areas looking pseudonodular with retractable centre at the left superior lobe and micronodulare isolated and confluent lesions at the level of the superior lobe. Sputum exam remains all negative for bK.(Koch bacil) Bronchoscopy shows only an inflammatory aspect. Bronchoalveolar lavage was negative microscopic directly exam but positive in culture after 3 months. Biological sensitivity: inflammatory syndrome (VSH - 48 mm/1 h), HIV negative. Histopathological exam after surgical excision of the tumor reveal a TB aspects.
CONCLUSIONS: development of asymptomatic pulmonary TB total of which within nine months has not outlined any change Rx. It is a very rare TB, Mechanism of tongue TB was likely due to haematogenous dissemination rather than by direct contamination (e.g. by negative BK in sputum exam)-patient with a good biological status
CLINICAL IMPLICATIONS: TB can locate anywhere and that not every tumor is cancer even in an older patient
DISCLOSURE: The following authors have nothing to disclose: Roxana Nemes, Emilia Tabacu, Gilda Popescu
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