Case report: Tuberculosis of parotid gland

Abstract

Primary tuberculosis of the parotid gland is an unusual clinical presentation. In this report a 32 years old male patient with parotid gland tuberculosis has been presented. The patient has been admitted to Ear, Nose & Throat outpatient clinic of our hospital with the complaint of left facial nodule. Histopathologic examination of the needle aspiration biopsy (NAB) specimen yielded benign necrotic lenfoid tissue, and in cervical ultrasonography cystic formations in left parotid gland were detected. Since the nodule size has increased in the follow-up period, cervical tomography was performed and heterogenous mass in the left side with lobular contour and hypodense appearance in posterior cervical region was detected. Histopathologic examination of the repeated NAB revealed chronic sialadenitis and benign lymphoid hyperplasia, and the patient has undergone left parotidectomy and lymph node dissection. Histopathologic examination of the excisional biopsy specimen revealed necrotising granuloma with diffuse caseification lesions concordant with tuberculosis. The patient was diagnosed as parotid gland tuberculosis, and anti-tuberculous therapy was started with isoniazid, rifampin, ethambutol and pyrazinamide. The history of the patient pointed out that he had used steroid for four months with a suspective diagnosis of rheumatoid arthritis, and his father had tuberculosis. In conclusion, since tuberculosis is a common infection in our country, it should be considered in the differential diagnosis of parotid nodules.