Secondary lingual tuberculosis with extensive oropharyngeal involvement demonstrated by F18-FDG PET/CT: a rare case report.
5 affiliations
- 1Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. [email protected].
- 2Department of Nuclear Medicine, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
- 3Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
- 4Department of Pathology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
- 5Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Abstract
Here, we present the case of a 42-year-old woman who presented with a clinical picture of odynophagia, hoarseness, cough, night sweats, and marked weight loss. Fluorodeoxyglucose positron emission tomography and computed tomography demonstrated heterogeneous hypermetabolic activity involving the oropharynx, nasopharynx and hypopharynx up to supraglottic larynx. Other findings were pulmonary miliary nodules with hypermetabolism, and mesenteric lymphadenopathy. Histopathology of a base-of-tongue biopsy revealed necrotizing granulomatous inflammation; however, Ziehl-Neelsen staining, mycobacterial culture, and polymerase chain reaction of the biopsy specimen, as well as sputum acid-fast bacilli examination, were all negative. In the absence of microbiological confirmation, a diagnosis of presumptive secondary lingual tuberculosis was established based on the combination of compatible clinical, radiological, and histopathological findings, after exclusion of alternative etiologies. The patient was empirically treated with a standard six-month four-drug anti-tuberculosis regimen, with rapid symptom improvement and complete recovery, remaining recurrence-free at the three-year follow-up. Our findings emphasize that tuberculosis should remain part of the differential diagnosis for persistent oral and oropharyngeal ulcerative lesions, especially when systemic findings coexist, even in the absence of microbiological confirmation. Fluorodeoxyglucose positron emission tomography and computed tomography can play a pivotal role in detecting disseminated disease and guiding targeted biopsies. Early diagnosis and prompt empirical therapy can lead to favorable long-term outcomes.
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BibTeX
@article{beytur2026secondary,
title = {{Secondary lingual tuberculosis with extensive oropharyngeal involvement demonstrated by F18-FDG PET/CT: a rare case report.}},
author = {Ayşe Nur Beytur and Muhammet Fatih Beytur and Rıdvan Karaali and Nuray Kepil and Kerim Sönmezoğlu and Neşe Saltoğlu},
journal = {BMC infectious diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14172-y},
url = {https://europepmc.org/article/MED/42968035},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Secondary lingual tuberculosis with extensive oropharyngeal involvement demonstrated by F18-FDG PET/CT: a rare case report.
AU - Ayşe Nur Beytur
AU - Muhammet Fatih Beytur
AU - Rıdvan Karaali
AU - Nuray Kepil
AU - Kerim Sönmezoğlu
AU - Neşe Saltoğlu
PY - 2026
DA - 2026/08/03
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14172-y
UR - https://europepmc.org/article/MED/42968035
AB - Here, we present the case of a 42-year-old woman who presented with a clinical picture of odynophagia, hoarseness, cough, night sweats, and marked weight loss. Fluorodeoxyglucose positron emission tomography and computed tomography demonstrated heterogeneous hypermetabolic activity involving the oropharynx, nasopharynx and hypopharynx up to supraglottic larynx. Other findings were pulmonary miliary nodules with hypermetabolism, and mesenteric lymphadenopathy. Histopathology of a base-of-tongue biopsy revealed necrotizing granulomatous inflammation; however, Ziehl-Neelsen staining, mycobacterial culture, and polymerase chain reaction of the biopsy specimen, as well as sputum acid-fast bacilli examination, were all negative. In the absence of microbiological confirmation, a diagnosis of presumptive secondary lingual tuberculosis was established based on the combination of compatible clinical, radiological, and histopathological findings, after exclusion of alternative etiologies. The patient was empirically treated with a standard six-month four-drug anti-tuberculosis regimen, with rapid symptom improvement and complete recovery, remaining recurrence-free at the three-year follow-up. Our findings emphasize that tuberculosis should remain part of the differential diagnosis for persistent oral and oropharyngeal ulcerative lesions, especially when systemic findings coexist, even in the absence of microbiological confirmation. Fluorodeoxyglucose positron emission tomography and computed tomography can play a pivotal role in detecting disseminated disease and guiding targeted biopsies. Early diagnosis and prompt empirical therapy can lead to favorable long-term outcomes.
SN - 1471-2334
ER -