Tuberculous Lymphadenitis of the Submandibular and Submental Lymph Nodes. A Case Report and Clinical Consideration.:A Case Report and Clinical Consideration

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• A case of tuberculous lymphadenitis occurred at the submandibular and submental lymph nodes is reported.<BR>A 53-year-old woman visited our department complaining of tumors at the right cervical region. She had recognized a submandibular tumor for 40 years, and a submental tumor separately emerged 4 years prior to the first visit.<BR>A computed tomography revealed solid mass with a hypodensity area in them, whereas an echosonogram revealed well-demarcated cystic lesions. Blood examinations were within normal limits, but purified protein derivative skin tests were positive. A chest roentgenogram disclosed no abnormality except a mediastinal shadow ascribed to previous cardiac surgery. An open biopsy was performed, and the histopathology revealed classic tubercles. The diagnosis was, therefore, tuberculous lymphadenitis of the submandibular and submental lymph nodes. Acid-fast bacilli was negative in the histologic specimen, as well as, in smear and culture of the sputum. Negative results were often encountered in the cervical tuberculous lymphadenitis. When negative results, an open biopsy should be undertaken for differential diagnosis.<BR><I>Mycobacterium tuberculosis</I> is not primarily vigorous in nature, and an asymptomatic lesion might be established as an equilibrium between the host and bacilli without aggressive clinical course. Immunodeficiency may destroy the equilibrium, followed by a systemic spread sometimes with fetal sequelae. The case, thus, allows us to speculate an adverse spread via lymphatic stream from the pre-existing lymphadenitis which was established in an immunocompromised status manifesting as herpes zoster of the breast. Despite undetected pathogenic germ, antituberculous regimen including chemotherapy should be initiated.

• 特定非営利活動法人 日本口腔科学会の論文

特定非営利活動法人 日本口腔科学会 | 論文

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