Is it Non-Hodgkin's lymphoma or tubercular lymphadenitis: A diagnostic dilemma?

The incidence of non-Hodgkin's lymphoma (NHL) is increasing, more so in tuberculosis (TB) endemic low and middle-income countries. Both of them have overlapping presentation that makes it difficult to differentiate them clinically. Here, we describe a case of 60-year-old male with oropharyngeal NHL with cervical and axillary lymphadenopathy. After completion of chemotherapy, there was complete resolution of oropharyngeal mass, but lymph nodes (LN) had responded partially. At this point, he was diagnosed with pulmonary TB and was started on antitubercular treatment (ATT). The residual LN resolved completely with the ATT. The patient is currently disease free. The case reported here highlights the dilemma in diagnosing a LN to be tubercular or lymphomatous.