Generalized BCG lymphadenitis in an infant: Diagnostic dilemma with lepromatous leprosy and Gaucher disease on fine needle aspiration

Abstract

A two-year old male infant with generalized BCG lymphadenitis is presented. There was no obvious immunodeficiency disorder detected in the patient. BCG vaccine had been given at two months of age, and the lymphadenopathy developed at 21 months of age. Fine needle aspiration biopsy of the lymph node on Giemsa stain revealed macrophages very similar to Gaucher cells. These cells also resembled macrophages seen in lepromatous leprosy. They were engorged with acid fast bacilli and had streaked or wrinkled cytoplasm. Mycobacterium bovis was cultured from the lymph nodes and the patients improved with antituberculous therapy.