Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease

(1) Background: Extrapulmonary tuberculosis (EPTB) of the head and neck is a rare but difficult diagnosis due to mostly absent pulmonary involvement and high clinical resemblance to neoplastic or chronic inflammatory conditions. This diagnosis still poses a challenge for otorhinolaryngologists, due...

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Main Authors: Carmen Aurelia Mogoantă, Andrei Osman, Alina-Maria Georgescu, Alexandra Maria Mitroi, Constantin Ioan Busuioc, Ionuţ Tănase, Ramona Cioboată, Ilona Mihaela Liliac, Ovidiu Lucian Cimpeanu, Mircea Sorin Ciolofan
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/14/5/479
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author Carmen Aurelia Mogoantă
Andrei Osman
Alina-Maria Georgescu
Alexandra Maria Mitroi
Constantin Ioan Busuioc
Ionuţ Tănase
Ramona Cioboată
Ilona Mihaela Liliac
Ovidiu Lucian Cimpeanu
Mircea Sorin Ciolofan
author_facet Carmen Aurelia Mogoantă
Andrei Osman
Alina-Maria Georgescu
Alexandra Maria Mitroi
Constantin Ioan Busuioc
Ionuţ Tănase
Ramona Cioboată
Ilona Mihaela Liliac
Ovidiu Lucian Cimpeanu
Mircea Sorin Ciolofan
author_sort Carmen Aurelia Mogoantă
collection DOAJ
description (1) Background: Extrapulmonary tuberculosis (EPTB) of the head and neck is a rare but difficult diagnosis due to mostly absent pulmonary involvement and high clinical resemblance to neoplastic or chronic inflammatory conditions. This diagnosis still poses a challenge for otorhinolaryngologists, due to non-specific symptoms and the low index of suspicion in non-endemic regions. (2) Methods: This study presents a retrospective review of nine cases of head and neck EPTB diagnosed at two regional hospitals in southern Romania. Patients presented with pharyngeal, laryngeal, or cervical lymph node involvement. All cases underwent surgical biopsies for histopathological and microbiological confirmation, followed by standard anti-tubercular therapy. (3) Results: In all nine cases, surgical biopsies were essential for the accurate diagnosis and excluded malignancy or other granulomatous diseases. Diagnostic delays were observed due to atypical clinical presentations. Integration of biopsy findings with anti-tubercular treatment resulted in favorable disease control and clinical recovery. (4) Conclusions: Head and neck EPTB requires a high index of suspicion and clinical discernment. Surgical biopsy remains a critical diagnostic tool in practice and should be considered early in the diagnostic process when encountering atypical lesions. A timely use improves diagnostic accuracy, may eliminate delays, ensures patient safety, and improves therapeutic outcomes.
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spelling doaj-art-2f9b6338ef3a445cbcafed12b4c1f2402025-08-20T01:56:44ZengMDPI AGPathogens2076-08172025-05-0114547910.3390/pathogens14050479Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary DiseaseCarmen Aurelia Mogoantă0Andrei Osman1Alina-Maria Georgescu2Alexandra Maria Mitroi3Constantin Ioan Busuioc4Ionuţ Tănase5Ramona Cioboată6Ilona Mihaela Liliac7Ovidiu Lucian Cimpeanu8Mircea Sorin Ciolofan9Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Anatomy and Embriology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Pathology, Sfânta Maria Hospital, 011172 Bucharest, RomaniaDepartment of Otorhinolaryngology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Pneumology, University of Medicine and Pharmacy, 200349 Craiova, RomaniaDepartment of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania(1) Background: Extrapulmonary tuberculosis (EPTB) of the head and neck is a rare but difficult diagnosis due to mostly absent pulmonary involvement and high clinical resemblance to neoplastic or chronic inflammatory conditions. This diagnosis still poses a challenge for otorhinolaryngologists, due to non-specific symptoms and the low index of suspicion in non-endemic regions. (2) Methods: This study presents a retrospective review of nine cases of head and neck EPTB diagnosed at two regional hospitals in southern Romania. Patients presented with pharyngeal, laryngeal, or cervical lymph node involvement. All cases underwent surgical biopsies for histopathological and microbiological confirmation, followed by standard anti-tubercular therapy. (3) Results: In all nine cases, surgical biopsies were essential for the accurate diagnosis and excluded malignancy or other granulomatous diseases. Diagnostic delays were observed due to atypical clinical presentations. Integration of biopsy findings with anti-tubercular treatment resulted in favorable disease control and clinical recovery. (4) Conclusions: Head and neck EPTB requires a high index of suspicion and clinical discernment. Surgical biopsy remains a critical diagnostic tool in practice and should be considered early in the diagnostic process when encountering atypical lesions. A timely use improves diagnostic accuracy, may eliminate delays, ensures patient safety, and improves therapeutic outcomes.https://www.mdpi.com/2076-0817/14/5/479extrapulmonary tuberculosistonsillar tuberculosislaryngeal tuberculosisunilateral cervical lymphadenopathyZiehl–Neelsen staining
spellingShingle Carmen Aurelia Mogoantă
Andrei Osman
Alina-Maria Georgescu
Alexandra Maria Mitroi
Constantin Ioan Busuioc
Ionuţ Tănase
Ramona Cioboată
Ilona Mihaela Liliac
Ovidiu Lucian Cimpeanu
Mircea Sorin Ciolofan
Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease
Pathogens
extrapulmonary tuberculosis
tonsillar tuberculosis
laryngeal tuberculosis
unilateral cervical lymphadenopathy
Ziehl–Neelsen staining
title Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease
title_full Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease
title_fullStr Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease
title_full_unstemmed Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease
title_short Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease
title_sort head and neck tuberculosis a rare diagnosis and the role of surgical biopsy and histopathological evaluation in extrapulmonary disease
topic extrapulmonary tuberculosis
tonsillar tuberculosis
laryngeal tuberculosis
unilateral cervical lymphadenopathy
Ziehl–Neelsen staining
url https://www.mdpi.com/2076-0817/14/5/479
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