J Rhinol.  2015 Nov;22(2):123-127. 10.18787/jr.2015.22.2.123.

A Two Cases of Primary Tuberculosis at the Nasopharynx

• Cho YS
• Choi N
• Kim HY

• KMID: 2223210
• DOI: http://doi.org/10.18787/jr.2015.22.2.123

Abstract

Upper airway tuberculosis usually develops as a secondary infection from pulmonary tuberculosis, and primary upper airway tuberculosis, especially in nasopharynx, is a rare disease. The appropriate treatment for nasopharyngeal tuberculosis has been difficult because of complicated initial diagnosis and suspicion. Physicians should consider various granulomatous diseases in differential diagnosis. However, upper airway tuberculosis can be highly contagious, like pulmonary tuberculosis; therefore, early diagnosis and proper management are important. We recently experienced the successful early diagnosis and treatment of two cases of nasopharyngeal tuberculosis and report these cases with a review of the literature.

Keyword

Nasopharynx; Tuberculosis

MeSH Terms

Coinfection
Diagnosis
Diagnosis, Differential
Early Diagnosis
Nasopharynx*
Rare Diseases
Tuberculosis*
Tuberculosis, Pulmonary

Figure

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  Fig. 1. Initial 90° endoscopic finding demonstrated necrotic tissue (black arrow) with purulent discharge on left lateral and posterior wall of nasopharynx (A), and right anterior moderate tympanic menbrane perforation with otorrhea (B). Follow-up examinations which were performed 1month after surgery showed completely healed nasopharynx (C), and decreased otorrhea of right ear (D).

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  Fig. 2. Preoperative computed tomography revealed poorly enhancing central soft tissue with peripheral rim enhancing lesion (white arrow) at the left lateral and posterior wall of nasopharynx.

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  Fig. 3. Nasopharyngeal tissue shows the caseous necrosis (black arrow head) and granulomatous inflammation with inflammatory cell infiltration in this photomicrograph of surgical biopsy (H&E, ×100).

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  Fi. 4. Initial 90o (A) and 30o (B) endoscopic finding demonstrated necrotic tissue (black arrow) and mucosal swelling with purulent discharge on nasopharynx wall entirely, Follow-up examinations which were performed 15 days after surgery showed partially improved of nasopharynx necrotic mucosa (C), and 1 month after surgery showed completely healed nasopharynx (D).

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  Fig. 5. Preoperative computed tomography showed increased enhancement and mild wall thickening of nasopharyngeal mucosa.

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  Fig. 6. Endoscopic debridement of nasopharynx.

Reference

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