PMC9386489_01
Nasopharyngoscopy showing thickened mucosa in the posterior wall of the nasopharynx covered with a thick, yellowish, purulent secretion that was not easily removed.
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In addition, nasopharyngoscopy showed thickened mucosa in the posterior wall of the nasopharynx, covered with a thick yellowish purulent secretion that was not easily removed (Figure 1).
(a and b) Computed tomography of the nasopharynx showing thickening of the mucosa on the right and left side walls and posterior wall with unclear margins. (c and d) Axial computed tomography images of the chest demonstrating centrilobular nodules with tree-in-bud opacification involving apical and anterior segments of the left upper lobe. And showed left-sided pleural thickening.
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Computed tomography of the nasopharynx showed mucosal thickening on the left and right sides of the wall and posterior wall with indistinct margins and multiple enlarged lymph nodes in the retropharyngeal space, left the palatine tonsillar area, and both sides of the neck (Figure 2a and b). Computed chest tomography displayed pulmonary tuberculosis in the upper lobe of the left lung and left-sided tuberculous pleurisy (Figure 2c and d).
(a and b) Grey scale ultrasound images of the neck demonstrating multiple enlarged hypoechoic lymph nodes bilaterally with areas of partial liquefaction and necrosis.
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Ultrasonography of cervical lymph nodes demonstrates multiple enlarged solid hypoechoic lymph nodes with well-defined borders, the largest on the right side measuring approximately 3.3 cm x 1.9 cm and the larger one on the left side measuring approximately 2.7 cm x 1.4 cm, with a few lymph nodes showing mildly increased vascularity and partial liquefaction (Figure 3a and b).
(a) Histopathological examination using hematoxylin-eosin staining at a microscopic magnification of 100x revealing epithelioid reaction. (b) Histopathological examination using hematoxylin-eosin staining at a microscopic magnification of 40x revealing multinucleated giant cells.
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Postoperatively, the specimen was stained with hematoxylin-eosin, and epithelioid reaction (Figure 4a) was found under microscopic magnification of 100x, and multinucleated giant cells (Figure 4b) were observed under magnification of 40x, suggesting nasopharyngeal tuberculosis granuloma.