The impact of tuberculosis misdiagnosis in Hodgkin lymphoma patients

The impact of tuberculosis misdiagnosis in Hodgkin lymphoma patientsSir, Both lymphoma and tubercular lymphadenopathy can present with similar clinical features, including fever, weight loss, and lymph node enlargement 1 .This overlap poses a significant diagnostic challenge, particularly in low/middle-income countries (LMICs), where tuberculosis (TB) is far more prevalent than lymphoma 2,3 .Due to limitations in healthcare infrastructure, patients presenting with these symptoms in LMICs are frequently started on empirical anti-tubercular therapy without a definitive diagnosis 4,5 .Recent advancements in the treatment of Hodgkin Lymphoma, such as the use of antibody-drug conjugates and checkpoint inhibitors, are associated with extremely high cure rates.However, due to high costs, these novel agents are often out of reach for most patients, and physicians have to rely on standard ABVD therapy, or use novel strategies such as lowdoses of these agents to achieve cure 6 .For patients with Hodgkin lymphoma who are misdiagnosed and initially treated with empirical anti-tubercular therapy, the impact of this delay on their clinical outcomes remains unclear.We aimed to evaluate the consequences of such misdiagnosis through this study.