Granuloma of the labial minor salivary glands in tuberculosis

Minor salivary gland granuloma is rare in tuberculosis. We present a case of labial minor salivary gland granulomas occurring in the course of tuberculosis along with skin, mediastinal and liver granulomas. The patient (46-year-old man) presented with asthenia, nocturne transpiration, weight loss and compressive thoracic adenopathies. The angiotensin I converting enzyme was elevated as well as calcemia. The QuantiFERON test and culture of a mediastinal specimen were positive for Mycobacterium tuberculosis. Multinucleated-cell-granulomas (focally with necrosis) were identified on skin, mediastinal, liver and minor salivary gland biopsies. Kidney biopsy was suggestive of IgA-glomerulonephritis. Treatment (isoniazid, rifampicin, ethambutol and moxifloxacin) was started and corticoids 15 days afterward. At 1 year, the patient had recovered. In conclusion, a case of labial minor salivary gland granulomas occurring in the course of tuberculosis is reported. Tuberculosis should be included in the differential diagnoses of labial minor salivary gland granulomas as treatments may be more complex than those for other granulomas including sarcoidosis.