# Coexistence of Tuberculous Lymphadenitis and Hodgkin Lymphoma: A Diagnostic Challenge

## TL;DR

A 10-year-old boy had both tuberculosis and Hodgkin lymphoma, showing how similar symptoms can make diagnosis difficult.

## Contribution

This case highlights the rare coexistence of tuberculous lymphadenitis and Hodgkin lymphoma.

## Key findings

- The patient was initially diagnosed with tuberculosis but showed no improvement with treatment.
- Repeated biopsies confirmed the presence of both tuberculosis and Hodgkin lymphoma in the same lymph node.
- The case underscores the need to consider malignancies in persistent lymphadenopathy in TB-endemic regions.

## Abstract

Hodgkin lymphoma (HL) and tuberculosis (TB) share overlapping clinical features, such as lymphadenopathy, fever, weight loss, and night sweats, which can complicate the diagnostic process, particularly in endemic regions. This case report describes a 10-year old boy with persistent cervical lymphadenopathy, initially diagnosed as tuberculous lymphadenitis based on fine-needle aspiration cytology (FNAC). The child was promptly started on anti-tubercular therapy (ATT), but his condition showed no improvement. Repeated biopsies ultimately revealed mixed cellularity HL, with the same lymph node testing positive for Mycobacterium tuberculosis, confirming a rare coexistence of both diseases. This case highlights the challenges clinicians face when both TB and HL are present, as the clinical symptoms may overlap. It also emphasizes the importance of considering malignancies as differential diagnoses in cases of persistent lymphadenopathy, even in TB-endemic regions.