Co-existence of pulmonary, tonsillar and laryngeal tuberculosis

A 56-year old male applied to otorhinolaryngology clinic with sore throat and dysphagia. During direct examination, ulcero-vegetative lesions were found in the left palatine tonsil and tonsil plicas. In the indirect laryngoscopy, ulcero-vegetative lesions were also observed in some regions of the larynx and epiglottis, Because of the suspicion of laryngeal carcinoma and metastasis, punch biopsy of the left palatine tonsil was performed. Chest X-ray and computerized tomography of the thorax revealed two adjacent cavitations in the apico-posterior segment of the left upper lobe. In the histopathologic examination of biopsies, granulomatous necrosis including caseification necrosis structures that proved tuberculosis was observed. In the fiberoptic bronchoscopic analysis, endobronchial lesion was not detected. Acid-fast bacilli were determined in sputum and bronchial lavage in microscopy and culture. The case of this middle aged male patient; with co-existence of tonsillar, laryngeal and pulmonary tuberculosis presents the clinical significance of upper airway tuberculosis in terms of its infectiousness and rare occurrence.