Pulmonary tuberculosis in children with Hodgkin's lymphoma.
The clinical presentation of tuberculosis (TB) and Hodgkin's lymphoma (HL) with pulmonary involvement is similar and raises problems of differential diagnosis. It may also be difficult to distinguish TB from relapsed lymphoma. The purpose of this study was to evaluate the association of HL and pulmonary TB and to discuss differential diagnosis. Medical records of 70 children were reviewed retrospectively. A total of 27 patients (38%) had mediastinal-pulmonary involvement initially. Systemic symptoms were present in 37 (52%) patients. In all, 14 patients (20%) had pulmonary TB; three of them were diagnosed as having TB before HL, two of them had TB and HL concomittantly at initial diagnosis, seven of them during lymphoma therapy and two of them after the cessation of lymphoma treatment. PPD was positive (>10 mm) only in seven patients. In all, 11 patients with pulmonary TB had diffuse pulmonary infiltrations and mediastinal enlargement at lung contrast-enhanced computed tomography and X-ray, which was difficult to differentiate from HL. Biopsies were performed in five patients. No mortality because of the infection was seen. Only one patient had been lost as relapsed-resistant HL. To evaluate mediastinal lymphadenopathies is very crucial and the differential diagnosis is difficult; hence the association between HL and the TB must be considered especially in countries where TB is highly endemic.
Karakas
Zeynep
Z
Department of Pediatrics, Istanbul School of Medicine, Istanbul University, Turkey. zeynepkar@hotmail.com
Agaoglu
Leyla
L
Taravari
Baki
B
Saribeyoglu
Ebru
E
Somer
Ayper
A
Guler
Nermin
N
Unuvar
Aysegul
A
Anak
Sema
S
Yalcin
Isik
I
Devecioglu
Omer
O
D000293:Adolescent; D000900:Anti-Bacterial Agents; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid; D002177:Candidiasis / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents