Problemy diagnostyczne i terapeutyczne u pacjenta z rakiem nosogardła i latentną gruźlicą – opis przypadku

Publication date: Available online 6 February 2016 Source:Pediatria Polska Author(s): Aleksandra Fatyga, Małgorzata Anna Krawczyk, Gabrielle Karpinsky, Andrzej Pustkowski, Dagmara Szmyd, Magdalena Markiewicz, Ewa Bień The coexistence of two rare conditions in the same patient is a challenge. This paper reports on a case of a 14.5-year-old boy diagnosed concurrently with latent tuberculosis infection (LTBI) and a nasopharyngeal carcinoma (NPC). The initial symptom was the enlargement of the right cervical lymph nodes. Ultrasound imaging was initially suggestive of LTBI. A positive skin tuberculin test and positive serological examination with interferon gamma release assays were conducted. However, the histopathological examination of the lymph nodes biopsy did not reveal acid-fast bacilli. Therefore, the diagnosis of LTBI was set. Histopathological examination of lymph nodes biopsy showed metastases of NPC. The primary tumour was revealed by magnetic resonance imaging in the nasopharynx. Based on the results of the positron emission tomography combined with computer tomography, the patient was classified to the stage IVB according to clinical classification of head and neck carcinomas (UICC/AJCC TNM 7 from 2009). Due to an advanced stage of NPC, intensive chemotherapy followed by a combined chemo-radiotherapy was initiated according to NPC-2003-GPOH protocol. Concurrently a chemoprophylactic treatment of tuberculosis infection, using isonicotinylhydrazide ...
Source: Pediatria Polska - Category: Pediatrics Source Type: research