Professional paper
https://doi.org/10.15644/asc51/4/7
Tuberculosis of the Oral Cavity Misdiagnosed as Precancerous Lesion
Vanja Vučićević Boras
orcid.org/0000-0003-1651-8069
; Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Dragana Gabrić
orcid.org/0000-0003-0213-1170
; Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Ljiljana Smiljanić Tomičević
; Department of Clinical Immunology and Rheumatology, Clinic for Internal Medicine, School of Medicine, University of Zagreb; Clinical Hospital Centre Zagreb, Zagreb, Croatia
Sven Seiwerth
; Department of Pathology, School of Medicine, University of Zagreb; Clinical Hospital Centre Zagreb, Zagreb, Croatia
Krešimir Gršić
orcid.org/0000-0002-2907-8640
; Department of Head and Neck Surgery, Clinic for Tumors, Clinical Hospital Centre “Sestre milosrdnice”, Zagreb, Croatia
Božena Šarčević
; Department of Pathology, Clinic for Tumors, Clinical Hospital Centre “Sestre milosrednice”, Zagreb, Croatia
Božena Lončar Brzak
; Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Emilija Marunica
; Clinic for Lung Diseases Jordanovac, Clinical Hospital Centre Zagreb, Zagreb, Croatia
Ana Glavina
; Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Introduction: The aim of this case report was to discuss an extremely rare oral lesion as a result of primary pulmonary tuberculosis. Case report: In this case report, the patient with refractory painless ulceration at ventral surface of the tongue was described. Detailed medical history was taken followed by clinical examination of the oral mucosa and palpation of regional lymph nodes. Clinical examination revealed ulceration on the patient’s ventro-lateral surface of the tongue, approximately two centimeters in diameter. Palpation of regional lymph nodes has not revealed enlargement. The toluidine blue test of the suspected lesion was performed at each control examination. Biopsy samples for histopathologic diagnosis were taken three times. The analysis of the first biopsy sample for histopathology revealed a non-specific inflammation, the second biopsy revealed a caseous necrosis
without positive Ziehl-Neelsen staining and the third biopsy revealed a granulomatous inflammation which was highly suspicious of sarcoidosis. During hospitalization, the patient underwent a complete physical examination, and laboratory and radiological diagnostics. Physical chest examination revealed bilaterally coarse crepitations and laboratory findings of his complete blood count revealed normocytic anemia of chronic disease. Radiographic examination of lungs showed multiple small nodules bilaterally and positive direct sputum smear. Conclusion: Although oral tuberculosis is a rare condition, it must be taken into account in differential diagnosis of refractory painless oral ulcers.
Keywords
Tuberculosis, Oral; Tongue, Oral Ulcer; Diagnostic Errors, Tuberculosis, Pulmonary
Hrčak ID:
190895
URI
Publication date:
18.12.2017.
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