The great imitator: Tuberculosis with lymphadenopathy and splenomegaly

Tuberculosis (TB) is a leading infectious killer worldwide. Over two-thirds of new TB diagnoses in the United States occur among first-generation immigrants, especially within a year of migration. Hodgkin lymphoma (HL) accounts for a minority of lymphoma cases but presents similarly to disseminated...

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Bibliographic Details
Published in:IDCases 2024, Vol.36, p.e01968, Article e01968
Main Authors: Hall, Ashton D., Rodriguez, Laura Victoria Medina, Vearrier, Jared, Patel, Kavya, Hambley, Bryan C., Huaman, Moises A.
Format: Article
Language:English
Subjects:
Atypical presentations
Extrapulmonary tuberculosis
Hodgkin lymphoma
Mycobacterium tuberculosis complex
Reed-Sternberg cells
Tuberculous lymphadenitis
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Summary:Tuberculosis (TB) is a leading infectious killer worldwide. Over two-thirds of new TB diagnoses in the United States occur among first-generation immigrants, especially within a year of migration. Hodgkin lymphoma (HL) accounts for a minority of lymphoma cases but presents similarly to disseminated or extrapulmonary TB. Clinical overlap between TB and HL increases patient risk of misdiagnosis. Concomitant presentation of both diseases is not uncommon but infrequently reported. We present a case of isoniazid-resistant TB with progressively worsening lymphadenopathy and splenomegaly despite appropriate TB treatment. The patient was diagnosed with HL following PET/CT and axillary lymph node biopsy. •A 33-year-old presented with active tuberculosis after immigrating to the US.•Imaging showed pulmonary involvement with lymphadenopathy and splenomegaly.•Axillary lymph node biopsy revealed Reed-Sternberg cells (CD15 +, CD30 +).•Tuberculosis may masquerade as multiple other diseases, including lymphoma.•Overlapping clinical profiles between TB and HL may delay diagnosis and treatment.
ISSN:2214-2509
2214-2509
DOI:10.1016/j.idcr.2024.e01968