Primary tuberculosis of submandibular gland.

Salivary gland tuberculosis is a rare pathology and does not always have the diagnostic guidelines led by previous tubercular localizations. Tubercular bacillus can reach the salivary gland in different ways, but the condition that most frequently causes a tubercular infection is the decay of the human organism defensive capacity toward the germ.A 15-year-old Romanian boy presented with a swelling in the left submandibular region. Normal extraoral, intraoral examination, and routine diagnostic examinations were performed. In order to make a final diagnosis, we performed a surgical left submandibular gland sialo-adenectomy operation to enable a histologic examination of the withdrawn tissue. Microscopic examination of the gland and lymph nodes showed a chronic necrotizing phlogosis of tubercular type. Previous routine examinations have been important only after final diagnosis to confirm that the submandibular tubercular localization was a primary infection. Diagnosis of this kind of disease is extremely difficult and is made with certainty only with the histologic examination, as happened in our case.

[Tuberculosis of the submandibular gland: a case report]. / Tuberculose de la glande sous-mandibulaire: un piège diagnostique.

INTRODUCTION: Tuberculosis remains an important public health problem in France. After a certain decline, its incidence has remained unchanged since 1990. 30% of tuberculosis cases are extra-pulmonary form, most of them concern nodes especially in cervical areas. CASE REPORT: This case of submandibular tuberculosis illustrates diagnostic and therapeutic difficulties. DISCUSSION: There are few clinical signs or laboratory clues suggestive of tuberculosis, however a surgery cannot be avoided and must be performed in combination with antituberculosis chemotherapy.

Parotid TB.

TB of the parotid is rare and only about 100 cases have been reported in the world literature. Often the diagnosis is made only after the surgery performed for a suspected neoplasm. We describe three patients with diffuse form of parotidTB without any evidence of tubercular focus elsewhere. Fine needle aspiration cytology confirmed the diagnosis in two cases, while the third case was diagnosed only after surgery.

Tuberculous otitis media: report of 2 cases on Long Island, N.Y., and a review of all cases reported in the United States from 1990 through 2003.

We report 2 cases of tuberculous otitis media that were diagnosed at Stony Brook University Hospital in New York since 1999. Both patients were women, aged 30 and 31 years. One patient had grown up in Russia, the other was a native-born American who had never left the East Coast region of the United States. Both patients had been symptomaticfor many months; one complainedof chronic otorrhea, and the other reported otorrhea, hearing loss, and discomfort. Neither patient responded to medical management, and both ultimately underwent surgery. One was diagnosed after surgical pathology revealed acid-fast bacilli on frozen-section analysis. In the other, pathology revealed chronic inflammation and granulomata, butstains were negative and her diagnosis was delayed for almost 2 years. We also review 9 other cases of tuberculous otitis media in the United States that have been reported in the literature since 1990. Our review suggests that the number of cases is rising in areas where tuberculosis is most common--that is, in major U.S. cities. Although 3 of these 9 cases occurred as reactivation disease in immigrants, most might have occurred as a result of local transmission. Clinicians should maintain a high degree of suspicion for tuberculosis in patients with chronic otitis symptoms, particularly those who are at higher risk of exposure to tuberculosis.

Primary tuberculosis of tongue.

A case of a 55 years old lady with tuberculosis of the tongue is reported. Patient presented with non-healing ulcer in dorsum of the tongue for one year. Initial biopsy and histopathological examination revealed non-specific inflammation. After surgery, biopsy report proved primary tuberculosis of tongue. Anti-tubercular therapy for nine months showed uneventful recovery of the patient.

Tuberculosis de la glándula submaxilar: aportación de dos casos clínicos / Tuberculosis of the submandibular gland: report of two clinical cases

Exponemos dos casos diagnosticados primariamente como sialoadenitis y que, posteriormente, resultaron ser una tuberculosis de la glándula submaxilar. Esta afeccón se presentea con una semiología inespecífica similar a una sialolitiasis. Aunque es más frecuente en nuestro medio la Tbc ganglionar que la glandular, debemos tener siempre presente que ante una adenopatía cervical habrá que descartar esta patología y que el diagnóstico definitivo lo vamos a realizar, tras la cirugía, con el examen anatomopatológico y bacteriológico. La PAAF junto con el test de Mantoux pueden ayudarnos en el diagnóstico prequirúrgico de la enfermedad

Parotid tuberculosis simulating malignancy.

An interesting case of parotid tumour simulating malignancy is reported. The rarity of this lesion and the associated clinical and diagnostic problems are emphasized together with the relevant literature.

Tuberculosis of the parotid gland.

The presentation of tuberculosis as an isolated parotid lump is rare. In this paper, six cases with tuberculous parotitis are reported which were evaluated as a benign parotid neoplasm in 216 specimens pre-operatively. All but one of them had no previous history of tuberculosis and all had a parotid lump as a sole symptom for at least one year. The diagnosis of tuberculosis was made, after superficial parotidectomy, by histopathology. Parenchymal involvement and intraparotid lymph node involvement with tuberculosis were seen in five and three patients, respectively. Two of the patients had lymph node involvement outside the parotid area. One of six patients had a coincidental Warthin tumour. A surgical approach is not only therapeutic but also diagnostic when other diagnostic tools fail.

Primary tonsillar tuberculosis: a case report.

A 67-year-old man with an enlarged left tonsil underwent a tonsillectomy for the suspicion of malignancy. He had had a dental extraction six months earlier. Clinical and histopathological investigations established the diagnosis of primary tonsillar tuberculosis.

Primary tuberculosis of the parotid gland.

A very unusual presentation of Mycobacterium tuberculosis in the parotid gland substance is described to suggest reexamination of the place of tuberculosis in the differential diagnosis of a parotid mass. In this patient, diagnosis was made postoperatively only by histologic examination of the excised specimen. When M. tuberculosis etiology is suspected, either clinically or at operation, culture confirmation should be tried, and a Mantoux test should be performed to complete the investigation.

Tuberculosis of the parotid gland: a case report.

A case of tuberculosis of the parotid gland, which involved the intraparotid lymph nodes of a 39-year-old Thai man is reported. The histologic characteristics of caseating granulomas with presence of acid and alcohol fast bacilli were criteria for diagnosis. This case is thought to be the first report of tuberculosis of the parotid gland in Thailand.

Long-term follow-up of the effect of tympanic neurectomy on sialadenosis and recurrent parotitis.

We examined the effect of tympanic neurectomy on the clinical symptoms and secretory function of the parotids in 13 patients with chronic parotitis or sialadenosis for 3 years. Each patient had significantly fewer complaints immediately after the surgery. In quite a few patients the improvement was transient only. Three years after neurectomy 3 of the 10 examined patients were free from complaints and 4 further patients had less severe complaints than before the surgery. Neurectomy was followed by a significant decrease in parotid flow rate and an increase in the sodium concentration of parotid saliva, while potassium concentration showed a slight decrease. Three years after the surgery the flow rate and the sodium concentration were moderately higher than before that. There was a significant, long-lasting change in the amylase activity of parotid saliva; 3 years after neurectomy it attained one-third of the preoperative value. A pharmacological test, carried out 3 years after neurectomy in 2 patients, suggested parasympathetic reinnervation of the parotid.

[Rare tumors of the base of the tongue and their therapy]. / Seltene Zungengrundtumoren und ihre Therapie.

Five rare tumours of the base of the tongue are reported. Diagnosis and therapy of a tuberculoma, an amyloid tumour, a mucoepidermoid carcinoma, a pleomorphic adenoma, and an angioleiomyoma are illustrated. The frequency and other possible sites of these tumours are discussed based on a review of the literature. The standard surgical approaches to the base of the tongue are described, favouring lateral pharyngotomy. The need for careful planning of the operation is stressed including difficulty in intubation and control of bleeding after operation.

[Tuberculosis of tongue (author's transl)]. / Zungentuberkulose

Report on a nodular form of tuberculosis of the tongue in a 91-year-old patient, which was cured completely by exstirpation and tuberculostatic therapy. The histologic examination of this "tumor of the tongue" lead to the radiologic proof of a chronic-specific lung process, which is interpreted as the source of the tuberculosis of the tongue by blood-stream dissemination. Discussion of the clinical and morphological forms of the tuberculosis of the tongue, of the differential diagnosis, as well as references to the importance of histologic examinations of ulcers of the tongue resulting in the detection of a specific lung process in some cases.