RESUMEN
Tuberculosis (TB) typically affects the lungs, but may involve many extra-pulmonary sites; with the latter especially prone in patients with human immunodeficiency virus infection. The clinical features of extra-pulmonary TB are often non-specific, mimicking many different disease entities. Application of the most appropriate imaging modality and knowing the imaging findings with clinical context awareness help initiation of further investigations, diagnosis and early treatment. This pictorial essay highlights the imaging spectrum of extra-pulmonary TB affecting the supra-thoracic region, i.e. brain, neck, and ear, nose and throat.
Asunto(s)
Tuberculosis , Humanos , Diagnóstico Diferencial , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Tuberculosis/diagnóstico por imagenRESUMEN
Primary sinonasal tuberculosis remains a diagnostic challenge as it mimics sinonasal granulomatous disease or neoplasms. Its characteristic signs and symptoms may be non-specific and highly variable. Here we report a unique clinical condition of a 24-year-old man who presented with unilateral nasal obstruction and epiphora for 2 years. He was without any comorbidity, was immunocompetent, and was otherwise healthy. Subsequent investigations, including a computed tomography scan of the paranasal sinuses, and perioperative findings revealed a sinonasal mass involving the lateral nasal wall and paranasal sinuses. The histopathology was consistent with the features of tuberculosis. There was no evidence of pulmonary or any other primary tubercular foci elsewhere in the body, suggesting the diagnosis of primary sinonasal tuberculosis.
RESUMEN
Primary sinonasal/nasal tuberculosis is rare amongst the commonly seen cases of extrapulmonary tuberculosis. We report three cases, two of primary sinonasal tuberculosis and one case of nasal tuberculosis in otherwise healthy patients. The diagnosis was based on radiological and histopathological findings. Treatment with antitubercular drug therapy was successful in all three of them. Sinonasal region tuberculosis, despite its rarity, should be added to differential diagnosis of nasal and paranasal sinus disorders particularly with intractable symptoms. Radiological imaging and nasal endoscopy with biopsy should be supplemented for confirmation.