case_images: PMC11730819_01
case_images: Axial 18F-FDG PET and PET/CT images in a 64-year-old man with nasopharyngeal tuberculosis. Pretreatment images show an abnormal 18F-FDG uptake on initial PET/CT over the nasopharynx, posterior wall. Malignant lesions could not be excluded and tissue confirmation was recommended. 18F-FDG = 18F-fluorodeoxyglucose, PET/CT = positron emission tomography/computed tomography.
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case_images: PMC11730819_01_medi-104-e40920-g001.jpg
case_images: F1
case_images: Therefore, the patient was referred to the otolaryngology department for further evaluation (Fig. 1).
case_images: Endoscopic findings of the nasopharyngeal mass. Nasopharynx was filled with round and smooth mass.
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case_images: F2
case_images: During the outpatient visit, laryngoscopy and flexible nasopharyngoscopy revealed bilateral hypertrophy of the palatine tonsils and a mass-like lesion in the nasopharynx (Figs. 2 and 3).
case_images: Axial 18F-FDG PET and PET/CT images with an abnormal 18F-FDG uptake on bilateral tonsils. endoscopic findings showed palatine tonsilar hypertrophy. 18F-FDG = 18F-fluorodeoxyglucose, PET/CT = positron emission tomography/computed tomography.
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case_images: PMC11730819_01_medi-104-e40920-g003.jpg
case_images: F3
case_images: During the outpatient visit, laryngoscopy and flexible nasopharyngoscopy revealed bilateral hypertrophy of the palatine tonsils and a mass-like lesion in the nasopharynx (Figs. 2 and 3).
case_images: Axial 18F-FDG PET and PET/CT images with an abnormal 18F-FDG uptake on bilateral neck lymph nodes. Ultrasound shows that the involved nodes are hypoechoic with echogenic thin layers. 18F-FDG = 18F-fluorodeoxyglucose, PET/CT = positron emission tomography/computed tomography.
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case_images: PMC11730819_01_medi-104-e40920-g004.jpg
case_images: F4
case_images: Needle aspiration biopsy of the left cervical lymph node showed benign cytologic findings (Fig. 4).
case_images: Pathologic findings of nasopharyngeal tuberculosis (H&E stain, X 20).
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case_images: F5
case_images: Endoscopic findings of the reduced size of nasopharyngeal mass lesion.
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case_images: F6
case_images: TB-PCR results were positive. The patient was diagnosed with extrapulmonary tuberculosis (TB) and is currently receiving anti-TB treatment with a 2-drug regemen (rifampicin, pyridoxine) for 3 months initally and 4-drug regimen (rifampicin, pyridoxine ethambutol, pyrazinamide) for 9 months additionally, which has shown a good response with continuous reduction in lesion size (Fig. 6). The patient is currently being followed-up with nasopharyngeal endoscopic exam monthly and there is no evidence of recurrence.