Muhammad Kashif Munir, Sana Rehman, Asif Hanif, Rizwan Iqbal.
T-Lymphoblastic Lymphoma concomitant with Cervical Lymph Node TB: a case report.
Pak J Chest Med Jan ;25(2):83-6.

Background: Concomitant occurrence of lymph node TB with any kind of lymphoma is scarce and challenging clinical manifestation for clinician to recognize and manage. T-lymphoblastic lymphoma is melanoma of underdeveloped precursors of T-cells to known as lymphoblasts. Cervical lymph node TB on the other hand is merely dependent on histopathology/cytology characterized by presence of granulomatous inflammation suggestive of TB and being used as primary tool to start anti tuberculosis treatment since long. Purpose of this report is to present a case of lymph node TB who showed chronic tonsillitis on starting the anti-tuberculosis treatment and diagnosed to be T-lymphoblastic lymphoma far later and lead to demise. Main pit fall in this specific case remained the delayed diagnosis of lymphoma due to systemic issues and slow response of ATT in even in general TB cases. Further occurrence of acute tonsillitis with aggression of cervical lymph nodes engaged the physician on other complications. All these factors create a lot of panic to the patient and resulted in almost diminished immunity. Patient lost resistance to fight with disease as well as with chemotherapy doses and passed away in young age. Vigilance of physician in rare etiologies is necessary to handle with such difficult and serious cases to avoid precious life losses.

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