Araştırma Makalesi
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Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy

Yıl 2020, Cilt: 4 Sayı: 9, 761 - 765, 01.09.2020
https://doi.org/10.28982/josam.784382

Öz

Aim: Tuberculosis diagnosis may be challenging and percutaneous biopsy may be required for definitive diagnosis. In this study, we aimed to investigate the utility of percutaneous biopsy in diagnosis of tuberculosis and radiological features of the tuberculosis cases diagnosed by image-guided biopsy.
Methods: The patients who were diagnosed with tuberculosis by image-guided biopsy between 2016 and 2020 in our institution were reviewed retrospectively in these case series. Histories of malignancy or immune deficiency, age and genders of the patients, localizations and radiological imaging findings of the lesions, needle types, imaging methods used for the biopsies and presumptive diagnoses before the biopsies were noted.
Results: A total of 16 patients (5 Females, 11 Males) with a mean age of 41 years (range: 17-74 years) had image-guided biopsy with presumptive diagnosis of infection or malignancy. Four patients had transthoracic core-needle-biopsy for lung masses, 12 had curettage-bone-biopsy for lytic lesions of vertebral and pelvic bones under CT-guidance. Four of the patients had immune deficiency and one had a history of malignancy. All patients were diagnosed with tuberculosis by both histopathological and culture analysis.
Conclusion: Image-guided-biopsy is safe and useful in the diagnosis of tuberculosis cases who could not be diagnosed by laboratory and sputum tests or those with presumptive diagnoses of malignancy. Tuberculosis should be kept in mind during percutaneous biopsy of radiologically suspicious cases as a differential diagnosis, even though they are clinically negative.

Kaynakça

  • 1. World Health Organization. Global tuberculosis control: WHO report 2011. World Health Organization. https://apps.who.int/iris/handle/10665/44728. Accessed: 8 March 2020.
  • 2. Global tuberculosis report 2017. Geneva: World Health Organization, 2017. http://www.who.int/tb/publications/global_report/gtbr2017_main_text.pdf. Accessed 8 March 2020.
  • 3. Hammen I. Tuberculosis mimicking lung cancer. Respir Med Case Rep. 2015;16:45–7. doi: 10.1016/j.rmcr.2015.06.007.
  • 4. Virenfeldt J, Rudolf F, Camara C, Furtado A, Gomes V, Aaby P, Petersen E, Wejse C. Treatment delay affects clinical severity of tuberculosis: a longitudinal cohort study. BMJ Open. 2014;4(6). doi: 004818 10.1136/bmjopen-2014-004818.
  • 5. Pesut DP, Marinkovic DM. Lung cancer and pulmonary tuberculosis-A comparative population-genetic study British. J Med Genetics. 2009;12:45–52.
  • 6. Bhatt M, Kant S, Bhaskar R. Pulmonary tuberculosis as differential diagnosis of lung cancer. South Asian J Cancer. 2012;1(1):36–42. doi: 10.4103/2278-330X.96507.
  • 7. Morikawa K, Misumi S, Fukuda T. A case of pulmonary tuberculosis with multiple nodules mimicking lung metastases. BJR Case Rep. 2019;5:20180124. doi: 10.1259/bjrcr.20180124.
  • 8. Falagas ME, Kouranos VD, Athanassa Z, Kopterides P. Tuberculosis and malignancy. Q J Med. 2010;103:461–87. doi: 10.1093/qjmed/hcq068.
  • 9. Ye M, Huang J, Wang J, Ren J, Tu J, You W, et al. Multifocal musculoskeletal tuberculosis mimicking multiple bone metastases: a case report. BMC Infect Dis. 2016;16:34. doi: 10.1186/s12879-016-1376-7.
  • 10. Lee Chul-Min, Lee S, Bae J . Contiguous Spinal Metastasis Mimicking Infectious Spondylodiscitis. Journal of the Korean Society of Radiology. 2015;73(6):408-12. https://doi.org/10.3348/jksr.2015.73.6.408.
  • 11. Alavi SM, Sharifi M. Tuberculous spondylitis: risk factors and clinical/paraclinical aspects in the south west of Iran. J Infect Public Health. 2010;3(4):196-200. doi: 10.1016/j.jiph.2010.09.005
  • 12. Altuwairgi O, Baharoon S, Alkabab Y, Alsafi E, Almoweqel M, L-Jahdali HA. Ultrasound-guided core biopsy in the diagnostic work-up of tuberculous lymphadenitis in Saudi Arabia, refining the diagnostic approach. Case series and review of literature. J Infect Public Health. 2014;7(5):371-6.
  • 13. Choo JY, Lee KY, Kim MY, Kang EY, Oh YW, Lee SH, et al. Pulmonary tuberculosis confirmed by percutaneous transthoracic needle biopsy: analysis of CT findings and review of correlations with underlying lung disease. Balkan Med J. 2014;31:208–13. doi: 10.5152/balkanmedj.2014.13187.
  • 14. Joo EJ, Yeom JS, Ha YE, Park SY, Lee CS, Kim ES, et al. Diagnostic yield of computed tomography-guided bone biopsy and clinical outcomes of tuberculous and pyogenic spondylitis. Korean J Intern Med. 2016;31(4):762–71. doi: 10.3904/kjim.2013.019.
  • 15. Cardella JF, Kundu S, Miller DL, Millward SF, Sacks D. Society of Interventional Radiology. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2009;20(7):189-91. doi: 10.1016/j.jvir.2009.04.035.
  • 16. Burrill J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR. Tuberculosis: a radiologic review. Radiographics. 2007;27(5):1255-73. doi: 10.1148/rg.275065176.

Görüntüleme eşliğinde biyopsi ile kanıtlanmış olan, maligniteyi taklit eden akciğer ve iskelet tüberkülozu vakaları

Yıl 2020, Cilt: 4 Sayı: 9, 761 - 765, 01.09.2020
https://doi.org/10.28982/josam.784382

Öz

Amaç: Tüberküloz tanısı bazı hastalarda zor olabilir ve kesin tanı için perkütan biyopsi gerekebilir. Bu çalışmada, görüntüleme eşliğinde biyopsi ile tanı alan tüberküloz olgularının radyolojik özelliklerini ve tüberküloz tanısında perkütan biyopsinin tanı koymadaki faydasını paylaşmayı amaçladık.
Yöntemler: Kurumumuzda 2016-2020 yılları arasında görüntüleme eşliğinde biyopsi ile tüberküloz tanısı alan hastalar, bu vaka serisi çalışmasında retrospektif olarak incelendi. Hastaların yaş ve cinsiyet bilgileri, biyopsi öncesi malignite veya immün yetersizlik öykülerinin olup olmadığı, lezyonların lokalizasyonları ve radyolojik görüntüleme bulguları, biyopsi için kullanılan iğne tipleri ve görüntüleme yöntemleri ile biyopsi öncesi ön tanıları not edildi.
Bulgular: Toplam 16 hastaya (5 Kadın, 11 Erkek; ortalama yaş 41; yaş aralığı 17-74), enfeksiyon veya malignite varsayımıyla birlikte görüntü rehberliğinde biyopsi yapıldı. Dört hastaya BT kılavuzluğunda akciğer kitleleri için transtorasik kalın iğne biyopsisi, 12 hastaya vertebral ve pelvik kemiklerdeki litik lezyonlar için kemik-küretaj biyopsisi uygulandı. Hastaların dördünde immün yetmezlik ve birinde malignite hikayesi vardı. Tüm hastalara hem histopatolojik hem de kültür analizi ile tüberküloz tanısı kondu.
Sonuç: Görüntüleme rehberliğinde biyopsi, laboratuvar ve balgam testleri ile teşhis edilemeyen veya malignite ön tanısı olan tüberküloz vakalarının tanısında güvenli ve yararlıdır. Radyolojik olarak şüpheli vakaların perkütan biyopsi işlemi sırasında, klinik olarak negatif de olsa, ayırıcı tanı olarak tüberküloz akılda tutulmalıdır.

Kaynakça

  • 1. World Health Organization. Global tuberculosis control: WHO report 2011. World Health Organization. https://apps.who.int/iris/handle/10665/44728. Accessed: 8 March 2020.
  • 2. Global tuberculosis report 2017. Geneva: World Health Organization, 2017. http://www.who.int/tb/publications/global_report/gtbr2017_main_text.pdf. Accessed 8 March 2020.
  • 3. Hammen I. Tuberculosis mimicking lung cancer. Respir Med Case Rep. 2015;16:45–7. doi: 10.1016/j.rmcr.2015.06.007.
  • 4. Virenfeldt J, Rudolf F, Camara C, Furtado A, Gomes V, Aaby P, Petersen E, Wejse C. Treatment delay affects clinical severity of tuberculosis: a longitudinal cohort study. BMJ Open. 2014;4(6). doi: 004818 10.1136/bmjopen-2014-004818.
  • 5. Pesut DP, Marinkovic DM. Lung cancer and pulmonary tuberculosis-A comparative population-genetic study British. J Med Genetics. 2009;12:45–52.
  • 6. Bhatt M, Kant S, Bhaskar R. Pulmonary tuberculosis as differential diagnosis of lung cancer. South Asian J Cancer. 2012;1(1):36–42. doi: 10.4103/2278-330X.96507.
  • 7. Morikawa K, Misumi S, Fukuda T. A case of pulmonary tuberculosis with multiple nodules mimicking lung metastases. BJR Case Rep. 2019;5:20180124. doi: 10.1259/bjrcr.20180124.
  • 8. Falagas ME, Kouranos VD, Athanassa Z, Kopterides P. Tuberculosis and malignancy. Q J Med. 2010;103:461–87. doi: 10.1093/qjmed/hcq068.
  • 9. Ye M, Huang J, Wang J, Ren J, Tu J, You W, et al. Multifocal musculoskeletal tuberculosis mimicking multiple bone metastases: a case report. BMC Infect Dis. 2016;16:34. doi: 10.1186/s12879-016-1376-7.
  • 10. Lee Chul-Min, Lee S, Bae J . Contiguous Spinal Metastasis Mimicking Infectious Spondylodiscitis. Journal of the Korean Society of Radiology. 2015;73(6):408-12. https://doi.org/10.3348/jksr.2015.73.6.408.
  • 11. Alavi SM, Sharifi M. Tuberculous spondylitis: risk factors and clinical/paraclinical aspects in the south west of Iran. J Infect Public Health. 2010;3(4):196-200. doi: 10.1016/j.jiph.2010.09.005
  • 12. Altuwairgi O, Baharoon S, Alkabab Y, Alsafi E, Almoweqel M, L-Jahdali HA. Ultrasound-guided core biopsy in the diagnostic work-up of tuberculous lymphadenitis in Saudi Arabia, refining the diagnostic approach. Case series and review of literature. J Infect Public Health. 2014;7(5):371-6.
  • 13. Choo JY, Lee KY, Kim MY, Kang EY, Oh YW, Lee SH, et al. Pulmonary tuberculosis confirmed by percutaneous transthoracic needle biopsy: analysis of CT findings and review of correlations with underlying lung disease. Balkan Med J. 2014;31:208–13. doi: 10.5152/balkanmedj.2014.13187.
  • 14. Joo EJ, Yeom JS, Ha YE, Park SY, Lee CS, Kim ES, et al. Diagnostic yield of computed tomography-guided bone biopsy and clinical outcomes of tuberculous and pyogenic spondylitis. Korean J Intern Med. 2016;31(4):762–71. doi: 10.3904/kjim.2013.019.
  • 15. Cardella JF, Kundu S, Miller DL, Millward SF, Sacks D. Society of Interventional Radiology. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2009;20(7):189-91. doi: 10.1016/j.jvir.2009.04.035.
  • 16. Burrill J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR. Tuberculosis: a radiologic review. Radiographics. 2007;27(5):1255-73. doi: 10.1148/rg.275065176.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme
Bölüm Araştırma makalesi
Yazarlar

Cennet Şahin 0000-0002-8695-327X

Eyup Camurcuoglu Bu kişi benim 0000-0002-2382-2555

Burcin Agridag Bu kişi benim 0000-0001-5406-9116

Selahattin Durmaz Bu kişi benim 0000-0002-2456-9483

Yayımlanma Tarihi 1 Eylül 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 4 Sayı: 9

Kaynak Göster

APA Şahin, C., Camurcuoglu, E., Agridag, B., Durmaz, S. (2020). Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy. Journal of Surgery and Medicine, 4(9), 761-765. https://doi.org/10.28982/josam.784382
AMA Şahin C, Camurcuoglu E, Agridag B, Durmaz S. Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy. J Surg Med. Eylül 2020;4(9):761-765. doi:10.28982/josam.784382
Chicago Şahin, Cennet, Eyup Camurcuoglu, Burcin Agridag, ve Selahattin Durmaz. “Image-Guided Biopsy-Proven Lung and Skeletal Tuberculosis Cases Mimicking Malignancy”. Journal of Surgery and Medicine 4, sy. 9 (Eylül 2020): 761-65. https://doi.org/10.28982/josam.784382.
EndNote Şahin C, Camurcuoglu E, Agridag B, Durmaz S (01 Eylül 2020) Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy. Journal of Surgery and Medicine 4 9 761–765.
IEEE C. Şahin, E. Camurcuoglu, B. Agridag, ve S. Durmaz, “Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy”, J Surg Med, c. 4, sy. 9, ss. 761–765, 2020, doi: 10.28982/josam.784382.
ISNAD Şahin, Cennet vd. “Image-Guided Biopsy-Proven Lung and Skeletal Tuberculosis Cases Mimicking Malignancy”. Journal of Surgery and Medicine 4/9 (Eylül 2020), 761-765. https://doi.org/10.28982/josam.784382.
JAMA Şahin C, Camurcuoglu E, Agridag B, Durmaz S. Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy. J Surg Med. 2020;4:761–765.
MLA Şahin, Cennet vd. “Image-Guided Biopsy-Proven Lung and Skeletal Tuberculosis Cases Mimicking Malignancy”. Journal of Surgery and Medicine, c. 4, sy. 9, 2020, ss. 761-5, doi:10.28982/josam.784382.
Vancouver Şahin C, Camurcuoglu E, Agridag B, Durmaz S. Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy. J Surg Med. 2020;4(9):761-5.