A late presentation of isolated lymph node tuberculosis postintravesical BCG therapy for superficial bladder cancer: a novel case

Journal article

Tasleem, A. M., Varga, B., Mahmalji, W. and Madaan, S. 2014. A late presentation of isolated lymph node tuberculosis postintravesical BCG therapy for superficial bladder cancer: a novel case. BMJ Case Reports. 2014. https://doi.org/10.1136/bcr-2014-204037
AuthorsTasleem, A. M., Varga, B., Mahmalji, W. and Madaan, S.
Abstract

Intravesical BCG immunotherapy is commonly used in the treatment of superficial bladder cancer. We recount the case of an 82-year-old British man who completed a course of BCG immunotherapy in 2011 for superficial bladder cancer, and presented in January 2013 with a loss of appetite, loss of weight and severe back pain. CT scanning, followed by MRI displayed a 5.7cm×5 cm conglomerated necrotic, haemorrhagic mass of lymph nodes in the para-aortic region. A CT-guided biopsy revealed granulomatous inflammation, focal fibrosis and acid-fast bacilli consistent with Mycobacterium tuberculosis (TB).

The patient was treated with combination antituberculous medication, and is recovering. To our knowledge, this is the only reported case of lymph node TB secondary to intravesical BCG immunotherapy. We suggest that in patients treated with postintravesical BCG with enlarged lymph nodes, a diagnosis of secondary TB should be considered.

KeywordsIntravesical BCG immunotherapy; BCG immunotherapy; Bladder cancer; Superficial bladder cancer
Year2014
JournalBMJ Case Reports
Journal citation2014
PublisherBMJ Publishing Group
ISSN1757-790X
Digital Object Identifier (DOI)https://doi.org/10.1136/bcr-2014-204037
Official URLhttps://casereports.bmj.com/content/2014/bcr-2014-204037
Publication dates
Online02 May 2014
Publication process dates
Accepted09 Apr 2014
Deposited05 Nov 2021
Output statusPublished
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Sanjeev Madaan, Steven Joniau, Katrien Klockaerts, Liesbeth DeWever, Evelyne Lerut, Raymond Oyen and Hendrik Van Poppel 2007. Segmental testicular infarction. Conservative management is feasible and safe: part 2. European Urology. 53 (3), pp. 656-658. https://doi.org/10.1016/j.eururo.2007.03.062
Key clinical issues in renal cancer: a challenge for proteomics
Rosamonde E. Bank, Rachel A. Craven, Patricia Harnden, Sanjeev Madaan, Adrian Joyce and Peter J. Selby 2007. Key clinical issues in renal cancer: a challenge for proteomics. World Journal of Urology. 25, pp. 537-556. https://doi.org/10.1007/s00345-007-0199-y
Unusual squamous cell carcinoma of the scrotum arising from a well healed, innocuous scar of an infertility procedure: a case report
Sanjeev Kotwal, Sanjeev Madaan, Stephen Prescott, Sameer Chilka and Peter Whelan 2007. Unusual squamous cell carcinoma of the scrotum arising from a well healed, innocuous scar of an infertility procedure: a case report. Annals of the Royal College of Surgeons of England. 89 (5), pp. W17-W-19. https://doi.org/10.1308/147870807X188498
Limitations of extracorporeal shock wave lithotripsy
Madaan, S. and Joyce, A. 2007. Limitations of extracorporeal shock wave lithotripsy. Current Opinion in Urology. 17 (2), pp. 109-113. https://doi.org/10.1097/MOU.0b013e32802b70bc
Omental metastasis with malignant ascites: an unusual manifestation of prostatic adenocarcinoma
Sanjeev Madaan, Victor Palit, Patricia Gudgeon and Chandra Shekhar Biyani 2007. Omental metastasis with malignant ascites: an unusual manifestation of prostatic adenocarcinoma. Canadian Urological Association Journal. 1 (3). https://doi.org/10.5489/cuaj.86
Ureteric complications of renal transplantation: the impact of the double J stent and the anterior extravesical ureteroneocystostomy
S. Guleria, R .Chahal, S. Madaan, H. C. Irving, C. G. Newstead, S. G. Pollard and J. P .A. Lodge 2005. Ureteric complications of renal transplantation: the impact of the double J stent and the anterior extravesical ureteroneocystostomy. Transplantation Proceedings. 37 (2), pp. 1054-1056. https://doi.org/10.1016/j.transproceed.2004.12.123
A complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient: a case for conservative management
Rohit Chahal, Sanjeev Madaan, Sandeep Guleria, J Peter A Lodge and John A Spencer 2004. A complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient: a case for conservative management. International Urology and Nephrology. 36, pp. 245-247. https://doi.org/10.1023/b:urol.0000034654.26422.f7
Transplant renal artery kinking: a rare cause of early graft dysfunction
Mohiuddin Miah, Sanjeev Madaan, David J Kessel, Charles G Newstead and Sandeep Guleria 2004. Transplant renal artery kinking: a rare cause of early graft dysfunction. Nephrology Dialysis Transplantation. 19 (7). https://doi.org/10.1093/ndt/gfh152
5-years outcome of a prospective randomised trial to compare Transurethral Electrovaporization of the Prostate (TUVP) to Standard Transurethral Resection (TURP)
Mohamed Y. Hammadeh, Sanjeev Madaan, John Hines and Timothy Philp 2003. 5-years outcome of a prospective randomised trial to compare Transurethral Electrovaporization of the Prostate (TUVP) to Standard Transurethral Resection (TURP). Urology. 61 (6), pp. 1166-1171. https://doi.org/10.1016/S0090-4295(03)00109-2
Androgen-dependent regulation of human MUC1 mucin expression
Stephen Mitchell, Paul Abel, Sanjeev Madaan, James Jeffs, Khurram Chaudhary, Gordon Stamp and El-Nasir Lalani 2002. Androgen-dependent regulation of human MUC1 mucin expression. Neoplasia. 4 (1), pp. 9-18. https://doi.org/10.1038/sj.neo.7900194
Cyclooxygenase-2: a possible target in schistosoma-associated bladder cancer
S.S. El-Sheikh, S. Madaan, A. Alhasso, P. Abel, G. Stamp and E.-N. Lalani 2002. Cyclooxygenase-2: a possible target in schistosoma-associated bladder cancer. BJU International. 88 (9), pp. 921-927. https://doi.org/10.1046/j.1464-4096.2001.01649.x
Genitourinary neurofibromatosis with prostatic involvement
Madaan, S., Hammadeh, S., Thomas, K., Philp, T. and Singh, M. 2001. Genitourinary neurofibromatosis with prostatic involvement. BJU International. 87 (903).
Cytoplasmic induction and over-expression of cyclooxygenase-2 in human prostate cancer: implications for prevention and treatment
S. Madaan, P.D. Abel, K.S. Chaudhary, R. Hewitt, M.A. Stott, G.W.H. Stamp and E.-N. Lalani 2001. Cytoplasmic induction and over-expression of cyclooxygenase-2 in human prostate cancer: implications for prevention and treatment. BJU International. 86 (6), pp. 736-741. https://doi.org/1046/j.1464-410x.2000.00867.x
A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy
Hammadeh, M. Y., Madaan, S., Singh, M. and Philp. T. 2001. A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy. BJU International. 86 (6), pp. 648-651. https://doi.org/10.1046/j.1464-410x.2000.00879.x
Cyclooxygenase-2 in prostate cancer
Madaan, S., Lalani, E-N. and Abel, P. D. 2000. Cyclooxygenase-2 in prostate cancer. Relias Media.
Urethral metastasis from a rectal adenocarcinoma
Madaan, S., Vohra, A. K., Riaz, A. A., Thomas, K. and Philp, T. 2000. Urethral metastasis from a rectal adenocarcinoma. BJU International. 86 (403).
Restorative proctocolectomy for collagenous colitis
Riaz, A. A,, Stirling, R. W., Madaan, S. and Dawson, P. M. 2000. Restorative proctocolectomy for collagenous colitis. Journal of the Royal Society of Medicine. 93 (5), pp. 261-261. https://doi.org/10.1177/014107680009300513