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Case Reports
. 2025 Dec 11;17(12):e98957.
doi: 10.7759/cureus.98957. eCollection 2025 Dec.

Non-Hodgkin Lymphoma and Tuberculosis Coexisting in the Same Cervical Lymph Node: A Case Report

Abdallah Taha  1 , Sara Alzhrani  2 , Nawaf Aljafari  2 , Bashar A Aljadani  2 , Abdullah Al-Rashdi  3 , Abdulrahman A Almuntashiri  4 , Khalid M Alkhalifah  5 , Wafa Bahshwan  6
Affiliations
Case Reports

Non-Hodgkin Lymphoma and Tuberculosis Coexisting in the Same Cervical Lymph Node: A Case Report

Abdallah Taha et al. Cureus. .

Abstract

We report the case of a 60-year-old female from Saudi Arabia who presented with a six-month history of a neck mass. Following an excisional biopsy under local anesthetic, laboratory analyses, including polymerase chain reaction (PCR), tuberculosis culture, and microscopic tissue examination, revealed the presence of diffuse large B-cell lymphoma (DLBCL) alongside tuberculous lymphadenitis in the cervical region. Immunohistochemistry confirmed DLBCL with CD20+, BCL6+, MUM1+, and Ki-67 80%. The patient was managed sequentially with anti-tuberculous therapy (ATT) followed by R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) regimen, achieving complete remission at six months with 12-month disease-free follow-up. This report highlights that lymphoma and tuberculous lymphadenitis can coexist. In patients undergoing lymph node biopsy for suspected tuberculosis, it is crucial to thoroughly assess for an underlying lymphoma. Detecting a malignancy in a cervical tuberculous lymph node significantly alters the therapeutic approach and requires coordinated management with medical oncology specialists.

Keywords: cervical lymph node; lymphoma; mycobacterium tuberculosis; non-hodgkin; tuberculosis.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Ultrasound of the neck showing a heterogeneous solid mass with a necrotic center (yellow arrow)
Figure 2
Figure 2. Contrast-enhanced CT of the neck showing a heterogeneous solid mass in the left lateral neck (yellow arrow)
CT: computed tomography
Figure 3
Figure 3. Hypothetical immunopathogenic sequence from chronic TB to DLBCL development
Exposure to Mycobacterium tuberculosis leads to chronic lymph node infection and persistent antigenic stimulation, triggering cytokine release (TNF-α, IL-6, IFN-γ), B-cell recruitment, and polyclonal expansion. Impaired T-cell immunity (e.g., due to CKD) and genetic instability culminate in monoclonal B-cell transformation to DLBCL, enhanced by BCL2-mediated apoptosis inhibition in the cytokine-driven microenvironment TB: tuberculosis; DLBCL: diffuse large B-cell lymphoma; TNF-α: tumor necrosis factor-alpha; IL-6: interleukin 6; IFN-γ: interferon-gamma; CKD: chronic kidney disease
See this image and copyright information in PMC

References

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