Tüberküloz akciğerin hemen hemen patolojik tüm durumlarını taklit edebilir ve çok çeşitli form ve görünümde ortaya çıkabilir. En sık izlenen radyolojik görünümler kaviter, fibroprodüktif, eksüdatif, asiner, makro ve mikronodüler ve milyer tiptir. Kliniğimize başvuran altı olgu (5 erkek, 38-74 yaşları arasında) değerlendirildi. Bu olgu serisi ile postprimer akciğer tüberkülozunun nadir olarak akciğer grafisi ya da tomografide kitle veya nodül görünümü gösterdiği ve neoplastik oluşumları taklit edebildiği tartışılarak hatırlatıldı. AnAhtAr Sözcükler: Akciğer kanseri, kitle, pulmoner tümör, tüberküloz Geliş Tarihi: 26.02.2012 Kabul Tarihi: 07.05.2012Tuberculosis can mimic all pathological considerations of the lung and can present in many various forms and appearances. Most common radiographic appearances are cavitary, fibroproductive, exudative, acinary, micro and macronodular and miliary types. Six patients (5 men; ages ranging from 38 to 74 years) who presented at our clinic during previous years were evaluated. In this case series report we discussed the consideration that, very rarely, postprimary lung tuberculosis presenting with large nodular and masslike forms in a chest X-ray or tomography scan, can be considered as having a neoplastic pattern.
Abstract
IntroductIonLung tuberculosis is often seen radiographically in the forms of cavitary, fibroproductive, exudative, acinary, micro and macronodular and miliary types [1]. However, quite variable radiographic appearances may present, mimicking all the other pathological formations of the lung and cause clinic difficulties for diagnosis.
CASE REPORTSThe general characteristics of the patients and the methods of diagnosis were summarized in Table 1 and 2.
Case 1A 38 year old female patient presented to our clinic with complaints of shortness of breath, fatigue, loss of appetite, weight loss and back pain ongoing from about one month. On her physical examination, bronchial sounds were heard in the left long upper zone and the other system examinations were normal. Biochemical and hematological values were within the normal range. On the tuberculin skin test (PPD test) of the patient who had a Bacillus-Calmette-Guerrin vaccine (BCG) scar, indurations was 20 mm and erythrocyte sedimentation rate (ESR) was 70 mm/hour. A partially smooth contoured homogenous mass lesion was observed in the left apical region on the postero-anterior (PA) chest radiograph. There was a wide pleural based hypodense solid mass lesion in the left lung upper lobe apicoposterior segment, extending to the mediastinum (Figure 1). Density increases related to alveolar type exudation were seen in the lung parenchyma adjacent to the mass. On bronchoscopy, the opening of the left lung upper lobe apicoposterior was blocked with a red colored mass. Acid fast bacilli (AFB) were found positive on the direct microscopic examination of the brushing material from here with Ehrlich-Ziehl-Nielsen stain (EZN). Standard anti-tuberculosis treatment was introduced with isoniazid (INH), riphampicine (RIF), etha...
