© 2003 Fellowship of Postgraduate Medicine
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A misleading swelling of the tongue
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A possibility of bacterial, fungal, and viral infections should be borne in mind when establishing a differential diagnosis.1 Tuberculosis, syphilis, histoplasmosis, and actinomycosis are some of the infections which may produce a sarcoidal type of tissue response or granulomas. Other possible entities are foreign body granuloma and orofacial granulomatosis such as oral Crohn’s disease, granulomatous cheilitis, and Melkersson’s syndrome.2 In this patient our clinical diagnosis was minor salivary gland tumour given the site of occurrence, and hard nodular swelling with overlying normal mucosa.
Clinical features along with histological evidence of non-caseating epithelioid granuloma from tissue biopsy can be supplemented by chest radiography, the presence of tuberculin anergy, a positive Kviem-Siltzbach skin test, a raised serum angiotensin converting enzyme, and by an increased 24 hour urine calcium level.3 The characteristic histological picture of sarcoidosis in all involved tissues is the non-caseating granuloma composed of aggregates of epithelioid cells, scattered multinucleated giant
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- A misleading swelling of the tongue
- D Simon, T Somanathan, and M Pandey
Postgrad. Med. J. 2003 79: 419-420.[Extract] [Full Text] [PDF]
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