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

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.