PDF herunterladen
CC BY-NC-ND 4.0 · South Asian J Cancer 2020; 09(04): 236-239
DOI: 10.1055/s-0041-1723629
Original Article: Paediatric Cancer

Tuberculosis Coexistence in Pediatric Hodgkin’s Lymphoma: A Tropical Country Experience

Maneya Padma
1   Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
Nuthan Kumar
1   Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
Jyothi Munireddy
1   Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
Arun Kumar
1   Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
Pooja Chebbi Gujjal
1   Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
S. Chennagiri Premalata
2   Department of Pathology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
› Institutsangaben Funding Nil.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Introduction Hodgkin’s lymphoma (HL), being one of the common cancers among children, may occasionally masquerade as an infectious illness. Similarly, an underlying infection like tuberculosis (TB) may be missed in cases of HL because of similarity in clinical and radiological features. Here, we present our data of association of HL with histopathologically proven TB lymph node, their clinical presentation, treatment details, and outcome.

Materials and Methods A retrospective review of all the cases of HL diagnosed between January 2007 and December 2016 was done. The cases which had an association of TB, based on the histopathology, were reviewed separately.

Results A total of 262 children with HL were treated at our institute from January 2007 to December 2016. Of these cases, 42 children had received empirical antitubercular therapy (ATT) (due to suspicion of TB) before presenting to us, and only five cases had histopathologically proven TB lymph node. Ziehl–Neelsen (ZN) stain for acid-fast bacilli (AFB) was positive in the biopsy specimen of all the five cases, proving TB lymph node coexistence with HL. They were treated with six-drug ATT as per the Revised National Tuberculosis Control Program (RNTCP) guidelines along with chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine regimen. All the five patients are healthy and disease free until their last follow-up.

Conclusion A high-end suspicion for concomitant TB and HL is needed, especially in our country where TB is still rampant. Biopsy with immunohistochemistry and demonstration of AFB can enable a definite diagnosis of both the entities.

Keywords

acid-fast bacillus - coexistence - Hodgkin’s lymphoma - tuberculosis


Publikationsverlauf

Artikel online veröffentlicht:
12. Juni 2021

© 2021. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Centkowski P, Sawczuk-Chabin J, Prochorec M, Warzocha K. Hodgkin’s lymphoma and tuberculosis coexistence in cervical lymph nodes. Leuk Lymphoma 2005; 46 (03) 471-475
    CrossrefPubMedGoogle Scholar
  • 2 Badyal RK, Sharma P, Prakash G, Malhotra P, Varma N. Hodgkin lymphoma masquerading as tuberculosis in a young chronic smoker. Indian J Hematol Blood Transfus 2014; 30 (Suppl. 01) 428-432
    CrossrefPubMedGoogle Scholar
  • 3 John TJ. Tuberculosis control: detect and treat infection in children. Indian Pediatr 2008; 45 (04) 261-264
    PubMedGoogle Scholar
  • 4 Kabra SK, Lodha R, Seth V. Some current concepts on childhood tuberculosis. Indian J Med Res 2004; 120 (04) 387-397
    PubMedGoogle Scholar
  • 5 Nachman JB, Sposto R, Herzog P. et al. Children’s Cancer Group. Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 2002; 20 (18) 3765-3771
    CrossrefPubMedGoogle Scholar
  • 6 World Health Organization; WHO Multicentre Growth Reference Study Group. Who Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development. Geneva, Switzerland: World Health Organization; 2006. Available at: http://www.who.int/childgrowth/standards/en/. Accessed November 19, 2020
  • 7 Pileri SA, Ascani S, Leoncini L. et al. Hodgkin’s lymphoma: the pathologist’s viewpoint. J Clin Pathol 2002; 55 (03) 162-176
    CrossrefPubMedGoogle Scholar
  • 8 Lister TA, Crowther D, Sutcliffe SB. et al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol 1989; 7 (11) 1630-1636
    CrossrefPubMedGoogle Scholar
  • 9 Cheson BD, Horning SJ, Coiffier B. et al. NCI Sponsored International Working Group. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. J Clin Oncol 1999; 17 (04) 1244
    CrossrefPubMedGoogle Scholar
  • 10 Revised National Tuberculosis Control Programme (RNTCP) – Guidelines for TB Control in India. Available at: http://www.searo.who.int/india/tuberculosis/topic/tb_rntcpguidelines/en/. Accessed November 19, 2020
  • 11 Pandey VK, Aggarwal P, Kakkar R, Modified BG. Prasad’s Socio-economic Classification-2018: The need of an update in the present scenario. Indian J Community Health 2018; 30: 82-84
    CrossrefGoogle Scholar
  • 12 Dannenberg Jr AM. Delayed-type hypersensitivity and cell-mediated immunity in the pathogenesis of tuberculosis. Immunol Today 1991; 12 (07) 228-233
    CrossrefPubMedGoogle Scholar
  • 13 Starke JR, Smith MH. Tuberculosis. In: Feigin RD, Cherry JD, eds. Textbook of Pediatric Infectious Diseases. 4th ed. Philadelphia:. WB Saunders Company 1998; 1196-239
    Google Scholar
  • 14 Sandherr M, von Schilling C, Link T. et al. Pitfalls in imaging Hodgkin’s disease with computed tomography and positron emission tomography using fluorine-18-fluorodeoxyglucose. Ann Oncol 2001; 12 (05) 719-722
    CrossrefPubMedGoogle Scholar
  • 15 Johnson LN, Iseri O, Knodell RG. Caseating hepatic granulomas in Hodgkin’s lymphoma. Gastroenterology 1990; 99 (06) 1837-1840
    CrossrefPubMedGoogle Scholar
  • 16 Radhakrishnan V, Dhanushkodi M, Ganesan TS. et al. Pediatric Hodgkin lymphoma treated at cancer institute, Chennai, India: Long-term outcome. J Glob Oncol 2016; 3 (05) 545-554
    CrossrefPubMedGoogle Scholar
  • 17 Karakas Z, Agaoglu L, Taravari B. et al. Pulmonary tuberculosis in children with Hodgkin’s lymphoma. Hematol J 2003; 4 (01) 78-81
    CrossrefPubMedGoogle Scholar
  • 18 Dres M, Demoule A, Schmidt M, Similowski T. Tuberculosis hiding a non-Hodgkin lymphoma “there may be more to this than meets the eye”. . Respir Med Case Rep 2012; 7: 15-16
    PubMedGoogle Scholar
  • 19 Codrich D, Monai M, Pelizzo G. et al. Primary pulmonary Hodgkin’s disease and tuberculosis in an 11-year-old boy: case report and review of the literature. Pediatr Pulmonol 2006; 41 (07) 694-698
    CrossrefPubMedGoogle Scholar
  • 20 Tavani A, La C Vecchia, Franceschi S, Serraino D, Carbone A. Medical history and risk of Hodgkin’s and non-Hodgkin’s lymphomas. Eur J Cancer Prev 2000; 9 (01) 59-64
    CrossrefPubMedGoogle Scholar