Abstract
Tuberculosis is a disease that occurs with different radiological manifestations. Although not frequent, tuberculosis cases seen as pulmonary masses have been reported in the literature. It is difficult to diagnose pulmonary tuberculosis definitely and to rule out a tumor in patients presenting with image of a pulmonary mass. In this paper, we discussed difficulties in diagnosis of two patients, aged 42 and 65 years, who admitted with a mass image on their chest x-rays to our clinic. Positron emission tomography images were taken following computerized tomography. Acid fast bacteria, bronchoalveolar lavage and bronchoscopic biopsies were not diagnostic. Therefore, surgery was used to establish the diagnosis. In the first patient, lobectomy was carried out with wedge resection due to peroperative suspected malignancy report of frozen section. Definitive report, however, yielded tuberculosis. Both patients received antituberculosis treatment and both were well at routine follow up examinations. Tuberculosis should be kept in mind when a mass is encountered in an endemic area such as our country. J Clin Exp Invest 2014; 5 (3): 462-465
Keywords
References
- Toloza EM, Harpole L, McCrory DC. Noninvasive stag- ing of non-small cell lung cancer a review of the cur- rent evidence. Chest 2003;123;137-146.
- Knight SB, Delbeke D, Stewart JR, Sandler MP. Evalu- ation of pulmonary lesions with FDG-PET. Compari- son of findings in patients with and without a history of prior malignancy. Chest 1996;109:982-988.
- Broughton WA, Bass Jr JB. Tuberculosis and diseases caused by atypical mycobacteria. In: Albert R, Spiro S, Jett J, Eds. Comprehensive Respiratory Medicine. New York: Mosby; 1999:296-297.
- Chawalparit O, Charoensak A, Chierakul N. HRCT of pulmonary tuberculosis mimics malignancy: a prelimi- nary report. J Med Assoc Thai 2006;89:190-195.
- Van den Brande P, Lambrechts M, Tack J, Demedts M. Endobronchial tuberculosis mimicking lung cancer in elderly patients. Respir Med 1991;85:107-109.
- Singh VK, Chandra S, Kumar S, et al. A common medical error: lung cancer misdiagnosed as spu- tum negative tuberculosis. Asian Pac J Cancer Prev 2009;10:335-338.
- Bhatt MLB, Kant S, Bhaskar R. Pulmonary tuberculosis as differential diagnosis of lung cancer. South Asian J Cancer 2012;1:36-42.
- Gadkowski LB, Stout JE. Cavitary pulmonary disease. Clin Microbiol Rev 2008;21:305–333.
- Sathekge MM, Maes A, Pottel H, et al. Dual time-point FDG PET-CT for differentiating benign from malignant solitary pulmonary nodules in a TB endemic area. S Afr Med J 2010;100:598-601.
- Nordin AJ, Rashmizal H, Abdul Rahim N, Rossetti C. Potential false positive active extra pulmonary tuber- culosis lesions on FDG PET/CT imaging in malignan- cy. Dicle Med J 2010;37:42-47.
- McAdams HP, Erasmus J, Winter JA. Radiologic manifestations of pulmonary tuberculosis. Radiol Clin North Am 1995;33:655-678.
Abstract
Tüberküloz farklı radyolojik görünümlerle ortaya çıkabilen bir hastalıktır. Sık olmamakla birlikte kitle görünümünde akciğer tüberkülozu olguları literatürde mevcuttur. Akciğerde kitle görünümü ile başvuran hastalarda tüberküloz tanısından emin olmak ve eşlik eden tümör tanısını kesin dışlamak bazen zor olmaktadır. Bu yazıda, kliniğimize akciğer grafiğinde kitle görünümü ile başvuran 42 ve 65 yaşındaki iki hastanın tanısında yaşanan güçlükler tartışıldı. Her iki olgunun bilgisayarlı tomografileri sonrası, Pozitron Emisyon Tomografileri çekildi. Üç kez bakılan balgamda Aside rezistans bakteri negatif idi. Fiberoptik bronkoskopik lavaj ve bronş biyopsileri negatif geldi. Bu nedenle her iki olguya cerrahi ile tanıya gidildi. İlk olguya mini torakotomi ile wedge rezeksiyonu yapıldı. Alınan parankim dokudan frozen (donmuş kesit) çalışıldı ve tüberkülozla uyumlu geldi. İkinci olgununda cerrahi sırasında frozen malign gelmesi nedeniyle sol üst lobektomi yapıldı. Ancak kesin patoloji raporu tüberküloz olarak geldi. Her iki olguya anti-tüberküloz tedavisi başlandı ve rutin kontrollerinde genel durumları iyi idi. Ülkemiz gibi tüberkülozun yaygın görüldüğü yerlerde akciğerde kitle görüntüsünde olan lezyonların değerlendirilmesinde tüberkülozun akılda tutulması gerekir.
Keywords
References
- Toloza EM, Harpole L, McCrory DC. Noninvasive stag- ing of non-small cell lung cancer a review of the cur- rent evidence. Chest 2003;123;137-146.
- Knight SB, Delbeke D, Stewart JR, Sandler MP. Evalu- ation of pulmonary lesions with FDG-PET. Compari- son of findings in patients with and without a history of prior malignancy. Chest 1996;109:982-988.
- Broughton WA, Bass Jr JB. Tuberculosis and diseases caused by atypical mycobacteria. In: Albert R, Spiro S, Jett J, Eds. Comprehensive Respiratory Medicine. New York: Mosby; 1999:296-297.
- Chawalparit O, Charoensak A, Chierakul N. HRCT of pulmonary tuberculosis mimics malignancy: a prelimi- nary report. J Med Assoc Thai 2006;89:190-195.
- Van den Brande P, Lambrechts M, Tack J, Demedts M. Endobronchial tuberculosis mimicking lung cancer in elderly patients. Respir Med 1991;85:107-109.
- Singh VK, Chandra S, Kumar S, et al. A common medical error: lung cancer misdiagnosed as spu- tum negative tuberculosis. Asian Pac J Cancer Prev 2009;10:335-338.
- Bhatt MLB, Kant S, Bhaskar R. Pulmonary tuberculosis as differential diagnosis of lung cancer. South Asian J Cancer 2012;1:36-42.
- Gadkowski LB, Stout JE. Cavitary pulmonary disease. Clin Microbiol Rev 2008;21:305–333.
- Sathekge MM, Maes A, Pottel H, et al. Dual time-point FDG PET-CT for differentiating benign from malignant solitary pulmonary nodules in a TB endemic area. S Afr Med J 2010;100:598-601.
- Nordin AJ, Rashmizal H, Abdul Rahim N, Rossetti C. Potential false positive active extra pulmonary tuber- culosis lesions on FDG PET/CT imaging in malignan- cy. Dicle Med J 2010;37:42-47.
- McAdams HP, Erasmus J, Winter JA. Radiologic manifestations of pulmonary tuberculosis. Radiol Clin North Am 1995;33:655-678.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | September 1, 2014 |
| Published in Issue | Year 2014 Volume: 5 Issue: 3 |