Disseminated Tuberculosis in a Mother with Diffuse Large B-cell Lymphoma resulting in Placental and Inferred Congenital Tuberculosis: An Autopsy Case Report

Publish : March 15, 2014
Total Download : 2

Worapop Suthiwartnarueput, M.D.1, Poonpilas Hongmanee, M.Sc.2, Jariya Waisayarat, M.D.2
1 Department of Pathology and Forensic Medicine, Faculty of Medicine, Thammasat university, Pathumthani, Bangkok, Thailand.
2 Department of Pathology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
Correspondence: Jariya Waisayarat, M.D. Email: jariya.wai@mahidol.ac.th
Received : 15 January 2014  Accepted : 10 March 2014

ABSTRACT


Background: Tuberculosis of the placenta is a rare condition which mainly occurs in the immunosuppressed individuals especially in acquired immune deficiency syndrome (AIDS) and hematologic malignancy9. Tuberculosis can spread to the fetus via hematogenous or cervicovaginal route and result in congenital tuberculosis.
Case report: We report a case of 25-year-old primigravida, who had stage IV diffuse large B-cell lymphoma of the gastric antrum. She presented with preterm premature rupture of membranes (PPROM) and developed acute respiratory distress syndrome (ARDS) of uncertain etiology after Caesarean section. She died 12 days following delivery of acute respiratory failure. Subsequent autopsy findings revealed diffuse organizing alveolar damage in the lung, with disseminated tuberculosis of the liver, spleen, peri-pancreatic lymph nodes and placenta. The infant delivered prematurely at 31 weeks gestation with 1685 gram birth weight. Despite extensive investigations showing negative results for TB culture, the infant was diagnosed as congenital tuberculosis and treated with anti-TB drugs. At one-year follow up, the infant was in good health and showed normal development.

Download

Address of editorial Corresponce
✎  Vorachai Sirikulchayanonta, MD, Editor-in-Chief: Asian Archives of Pathology, Faculty of Science, Rangsit University, Pathumthani 12000, Thailand.
✉  Email address: asianarchpath@gmail.com, vorachai7@gmail.com