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반우호 ( Woo Ho Ban ),강현희 ( Hyeon Hui Kang ),백명기 ( Myong Ki Baeg ),김재경 ( Jae Gyung Kim ),김현진 ( Hyun Jin Kim ),백인운 ( In Woon Baek ),김은오 ( Eun Oh Kim ),고선혜 ( Sun Hye Ko ),이상학 ( Sang Haak Lee ),문화식 ( Hwa Si 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.4
Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin`s lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.