H Ramotar1, L Cheung1, L Pitkin2. 1. Department of ENT Surgery,Frimley Park Hospital,Guildford,UK. 2. Department of ENT Surgery,Royal Surrey County Hospital,Guildford,UK.
Abstract
BACKGROUND: Inflammatory pseudotumours of the head and neck are rare. A connection has been made between inflammatory pseudotumours and human immunodeficiency virus positivity. CASE REPORT: This paper reports a case of an inflammatory pseudotumour presenting with a lesion in the left tonsil and left cervical lymph node in a 49-year-old human immunodeficiency virus positive patient. A histological diagnosis was obtained after biopsy and serial radiological imaging. CONCLUSION: Diagnostic uncertainties can lead to unnecessary surgery. It is important to recognise the clinical, radiological and histological indicators of an inflammatory pseudotumour to enable a timely diagnosis and arrange appropriate treatment. In patients with co-morbidities causing immunocompromise, the potential diagnosis of an inflammatory pseudotumour should be considered. This is especially the case in human immunodeficiency virus patients, as inflammatory pseudotumours have been associated with immune reconstitution inflammatory syndrome, which can manifest up to several years after the initiation of, or change in, antiretroviral therapies.
BACKGROUND: Inflammatory pseudotumours of the head and neck are rare. A connection has been made between inflammatory pseudotumours and human immunodeficiency virus positivity. CASE REPORT: This paper reports a case of an inflammatory pseudotumour presenting with a lesion in the left tonsil and left cervical lymph node in a 49-year-old human immunodeficiency virus positive patient. A histological diagnosis was obtained after biopsy and serial radiological imaging. CONCLUSION: Diagnostic uncertainties can lead to unnecessary surgery. It is important to recognise the clinical, radiological and histological indicators of an inflammatory pseudotumour to enable a timely diagnosis and arrange appropriate treatment. In patients with co-morbidities causing immunocompromise, the potential diagnosis of an inflammatory pseudotumour should be considered. This is especially the case in human immunodeficiency viruspatients, as inflammatory pseudotumours have been associated with immune reconstitution inflammatory syndrome, which can manifest up to several years after the initiation of, or change in, antiretroviral therapies.
Entities:
Keywords:
Granuloma; HIV; Head And Neck Neoplasms; Histology; Inflammatory Pseudotumors; Lymph Nodes; Plasma Cell; Radiology
Authors: Ramesh Babu Telugu; Anne Jennifer Prabhu; Nobin Babu Kalappurayil; John Mathai; Birla Roy Gnanamuthu; Marie Therese Manipadam Journal: J Pathol Transl Med Date: 2017-04-17