Tuberculosis of the Nasopharynx: A Rare Entity Revisited

• Published in: The Laryngoscope Vol. 113; no. 4; pp. 737 - 740
• Main Authors: Tse, Gary M. K., Ma, Tony K. F., Chan, Amy B. W., Ho, Fiona N. Y., King, Ann D., Fung, Kitty S. C., Ahuja, Anil T.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ John Wiley & Sons, Inc 01-04-2003; Wiley-Blackwell
• Subjects: Adult; Aged; Bacterial diseases; Biological and medical sciences; Female; granuloma; granulomatous inflammation; Human bacterial diseases; Humans; Infectious diseases; Lymphatic Diseases - complications; Male; Medical sciences; Middle Aged; Nasopharyngeal Diseases - complications; Nasopharyngeal Diseases - pathology; Nasopharynx; Neck; Non tumoral diseases; Otorhinolaryngology. Stomatology; Retrospective Studies; tuberculosis; Tuberculosis - complications; Tuberculosis - pathology; Tuberculosis and atypical mycobacterial infections; undifferentiated carcinoma; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Human; Characteristic; Nasopharynx; Mycobacterial infection; Retrospective; Infection; undifferentiated carcinoma; Pathology; Symptomatology; Histopathology; Tuberculosis; granuloma; Bacteriosis; ENT disease; Pharynx disease; Clinical investigation; Diagnosis; granulomatous inflammation
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/00005537-200304000-00027

Objectives Tuberculosis of the nasopharynx is uncommon. A large series of 17 cases is reported, and the clinical and pathological features are discussed.
Study Design A retrospective review.
Methods Seventeen archived cases of biopsy‐proven nasopharyngeal tuberculosis were reviewed for patient age and sex, presenting complaint and duration, systemic symptoms, cervical lymphadenopathy, and chest x‐ray findings. These findings were compared with a compilation of 40 cases reported in the English literature.
Results There was a female predominance (13 women and 4 men), with age range of 20 to 74 years (mean age, 38 y). The most common presentation was enlargement of the cervical lymph nodes (53%), followed by hearing loss (12%), tinnitus, otalgia, nasal obstruction, and postnasal drip (6% each). The duration of the presenting symptoms ranged from 1 week to 1 year (mean duration, 16 wk). Ten patients (59%) had cervical lymphadenopathy, two (12%) had systemic symptoms (fever, weight loss, night sweats), and one patient (6%) had miliary pulmonary tuberculosis. Direct endoscopic examination showed nasopharyngeal mucosal irregularity or mass in the majority of patients (12 patients [70%]). These features were similar to those reported in the literature.
Conclusions Nasopharyngeal tuberculosis is uncommon, usually occurring without pulmonary or systemic involvement. Cervical lymphadenopathy occurs in more than half of the patients and is the most common presenting complaint; this, together with the nasopharyngeal findings of mass or mucosal irregularity, makes differentiation from carcinoma on clinical examination difficult, necessitating histological evaluation.