A 62-year-old man presented with bilateral nasal obstruction and recurrent epistaxis episodes. Physical examination revealed normal body temperature and free cervical lymph nodes areas. Nasal endoscopy found a congest...A 62-year-old man presented with bilateral nasal obstruction and recurrent epistaxis episodes. Physical examination revealed normal body temperature and free cervical lymph nodes areas. Nasal endoscopy found a congestive nasal mucosa associated to bilateral inferior turbinate hypertrophy with a granular aspect of the right inferior turbinate. The biological examination showed lymphopenia, inflammatory syndrome, high serum level of angiotensin-converting enzyme and β2 microglobulin. Tuberculin skin test and Quantiferon gold were negative. The nasal and accessory salivary gland biopsies revealed granulomatous giant cell lesions non-caseating evoking systemic sarcoidosis. Ziehl-Neelsen staining and Lowenstein culture were negative. The diagnosis was systemic sarcoidosis revealed by nasal localization. The systemic extension research was negative. The treatment was based on corticosteroids (1 mg/kg/day) and gradual degression doses associated to a local nasal corticosteroid. The outcome was favorable with improvement of nasal obstruction and disappearance of initial lesions. The follow-up was 2 years.展开更多
Primary laryngeal tuberculosis is rare. It can manifest as a malignancy delaying the diagnosis and the therapeutic management. We report the case of a 34-year-old immunocompetent man whose plaints were fever, sweat an...Primary laryngeal tuberculosis is rare. It can manifest as a malignancy delaying the diagnosis and the therapeutic management. We report the case of a 34-year-old immunocompetent man whose plaints were fever, sweat and dysphonia. There were no adenopathy, nor hepatosplenomegaly. Several blood cultures were negative. Laboratory studies showed an inflammatory syndrome. In addition, the bacteriological examinations of sputum and urine in search of Mycobacterium tuberculosis were negative. Laryngoscopy confirmed the presence of a thickness of the right vocal cord and an ulcer in the hemilarynx. The histological examination revealed tuberculoid granulomas suggestive of tuberculosis. The culture from vocal cord tissue for Mycobacterium tuberculosis was positive. No other focus of tuberculosis was found on X-ray and computed tomography. Treatment by a combination of isoniazid, rifampicin, pyrazinamide induced a total resolution of symptoms.展开更多
Primary non-Hodgkin’s lymphoma of the thyroid gland was rarely described. We report the case of a 44-year-old man admitted for an anterior neck swelling, hoarseness and dyspnea. The chest radiograph showed a trachea ...Primary non-Hodgkin’s lymphoma of the thyroid gland was rarely described. We report the case of a 44-year-old man admitted for an anterior neck swelling, hoarseness and dyspnea. The chest radiograph showed a trachea deviation. He had no clinical, biological or radiological sign of other lymphoma locations. Ultrasound examination of the neck revealed a bilateral heterogeneous thyroid lesion. Cytology revealed lymphoid cells having high nuclear-cytoplasmic ratio with multiple and irregular nucleoli. An urgent thyroid surgery consisting of total thyroidectomy had been performed since the presence of compressive signs due to the tumor. The histopathological examination of a biopsy from the thyroid tissue confirmed a high-grade non-Hodgkin’s lymphoma. Then, L-thyroxin substitution therapy, chemotherapy and radiotherapy were initiated. A prolonged remission was noted.展开更多
文摘A 62-year-old man presented with bilateral nasal obstruction and recurrent epistaxis episodes. Physical examination revealed normal body temperature and free cervical lymph nodes areas. Nasal endoscopy found a congestive nasal mucosa associated to bilateral inferior turbinate hypertrophy with a granular aspect of the right inferior turbinate. The biological examination showed lymphopenia, inflammatory syndrome, high serum level of angiotensin-converting enzyme and β2 microglobulin. Tuberculin skin test and Quantiferon gold were negative. The nasal and accessory salivary gland biopsies revealed granulomatous giant cell lesions non-caseating evoking systemic sarcoidosis. Ziehl-Neelsen staining and Lowenstein culture were negative. The diagnosis was systemic sarcoidosis revealed by nasal localization. The systemic extension research was negative. The treatment was based on corticosteroids (1 mg/kg/day) and gradual degression doses associated to a local nasal corticosteroid. The outcome was favorable with improvement of nasal obstruction and disappearance of initial lesions. The follow-up was 2 years.
文摘Primary laryngeal tuberculosis is rare. It can manifest as a malignancy delaying the diagnosis and the therapeutic management. We report the case of a 34-year-old immunocompetent man whose plaints were fever, sweat and dysphonia. There were no adenopathy, nor hepatosplenomegaly. Several blood cultures were negative. Laboratory studies showed an inflammatory syndrome. In addition, the bacteriological examinations of sputum and urine in search of Mycobacterium tuberculosis were negative. Laryngoscopy confirmed the presence of a thickness of the right vocal cord and an ulcer in the hemilarynx. The histological examination revealed tuberculoid granulomas suggestive of tuberculosis. The culture from vocal cord tissue for Mycobacterium tuberculosis was positive. No other focus of tuberculosis was found on X-ray and computed tomography. Treatment by a combination of isoniazid, rifampicin, pyrazinamide induced a total resolution of symptoms.
文摘Primary non-Hodgkin’s lymphoma of the thyroid gland was rarely described. We report the case of a 44-year-old man admitted for an anterior neck swelling, hoarseness and dyspnea. The chest radiograph showed a trachea deviation. He had no clinical, biological or radiological sign of other lymphoma locations. Ultrasound examination of the neck revealed a bilateral heterogeneous thyroid lesion. Cytology revealed lymphoid cells having high nuclear-cytoplasmic ratio with multiple and irregular nucleoli. An urgent thyroid surgery consisting of total thyroidectomy had been performed since the presence of compressive signs due to the tumor. The histopathological examination of a biopsy from the thyroid tissue confirmed a high-grade non-Hodgkin’s lymphoma. Then, L-thyroxin substitution therapy, chemotherapy and radiotherapy were initiated. A prolonged remission was noted.
