Clinicopathological analysis of nasopharyngeal tuberculosis

Ann Med. 2024 Dec;56(1):2406440. doi: 10.1080/07853890.2024.2406440. Epub 2024 Sep 25.

Abstract

Background: The aim of this study is to examine the clinical and pathological attributes of nasopharyngeal tuberculosis.

Methods: We conducted a retrospective analysis of the clinicopathologic characteristics of nasopharyngeal tuberculosis in 14 patients. The medical records and imaging data obtained between March 2004 and February 2023 were scrutinized. During the pathological review, we classified the types of granulomatous inflammation and graded the extent of caseation.

Results: Results indicate a 100% female predominance, with chief complaints including hearing loss, postnasal drip, and nasal obstruction. Cervical lymphadenopathy occurred in 21.4% of patients. Chest radiograph abnormalities were found in 58.3%, with three showing active pulmonary tuberculosis. Endoscopic examination revealed three types of lesions, and CT/MRI findings correlated with gross lesions. A statistically significant association was found between lesion characteristics (bulging, ulcerative, necrotic) and pathology patterns (sarcoidosis-like, caseation). Bulging masses exhibited sarcoidosis-like patterns, while ulcerative/necrotic lesions were often associated with caseation. All lesions responded well to over six months of anti-tuberculosis medication, leading to favourable outcomes.

Conclusion: We studied 14 cases of nasopharyngeal tuberculosis, mostly in females, with common ear and nose symptoms. Lesions were typically visible on nasopharyngeal endoscopy, and endoscopically bulging mass-like lesions had pathologically sarcoidosis-like granulomas. All patients had favourable outcomes.

Keywords: Nasopharynx; endoscopy; granuloma; tuberculosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / therapeutic use
  • Endoscopy
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nasopharyngeal Diseases* / diagnosis
  • Nasopharyngeal Diseases* / diagnostic imaging
  • Nasopharyngeal Diseases* / drug therapy
  • Nasopharyngeal Diseases* / microbiology
  • Nasopharyngeal Diseases* / pathology
  • Nasopharynx / diagnostic imaging
  • Nasopharynx / microbiology
  • Nasopharynx / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Tuberculosis / diagnosis
  • Tuberculosis / diagnostic imaging
  • Tuberculosis / epidemiology
  • Tuberculosis / pathology
  • Young Adult

Substances

  • Antitubercular Agents

Grants and funding

The research did not obtain financial support from any funding agency in the public, private, or nonprofit domains.