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When infection and malignancy intersect in Rwanda: A diagnostic challenge in the tropics—Case Report
Tuan, J.; Nkeshimana, M.; Masaisa, F.; Manirakiza, F.; Ruhangaza, D.; Murayire, J.; Mukanumviye, M.S; Kubwayo, A.P.; Niyigena, O.; Habanabakize, T.; Byukusenge, M.; Niyoyita, B.; Moise, I.S.; Niyotwambaza, J. & Kailani, L.
Abstract
CASE PRESENTATION: We describe a 38-year-old Rwandan male patient who presented to the hospital with a two-week history of left axillary lymphadenopathy, fever, weight loss, and one-year history of dysphagia. Lymph node fine needle aspirate was consistent with tuberculous lymphadenitis. Peripheral blood smear suggested a concomitant diagnosis of Acute Myeloid Leukemia (AML), which was confirmed by bone marrow biopsy. Although several cases of concurrent pulmonary tuberculosis and AML exist, fewer cases of concomitant tuberculous lymphadenitis and AML have been reported.
CONCLUSION: This case highlights the need to keep a high suspicion for malignancy in a patient with lymphadenopathy, leukocytosis, and constitutional symptoms; at the same time, a coexisting opportunistic infection such as tuberculosis should not be overlooked in the tropical clinical setting.
Keywords
Tuberculous Lymphadenitis; Acute Myeloid Leukemia; Lymphadenopathy; Immune Reconstitution Inflammatory Syndrome; Fine-Needle Biopsy; Immunohistochemistry; Leukocytosis; Pulmonary Embolism; Splenomegaly
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