The great imitator: Tuberculosis with lymphadenopathy and splenomegaly

Ashton D Hall; Laura Victoria Medina Rodriguez; Jared Vearrier; Kavya Patel; Bryan C Hambley; Moises A Huaman

doi:10.1016/j.idcr.2024.e01968

The great imitator: Tuberculosis with lymphadenopathy and splenomegaly

IDCases. 2024 Apr 16:36:e01968. doi: 10.1016/j.idcr.2024.e01968. eCollection 2024.

Authors

Ashton D Hall¹, Laura Victoria Medina Rodriguez², Jared Vearrier³, Kavya Patel¹, Bryan C Hambley⁴, Moises A Huaman¹

Affiliations

¹ Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
² Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
³ Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁴ Division of Hematology and Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Abstract

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.

Keywords: Atypical presentations; Extrapulmonary tuberculosis; Hodgkin lymphoma; Mycobacterium tuberculosis complex; Reed-Sternberg cells; Tuberculous lymphadenitis.

Publication types

Case Reports