Bilateral nodular pulmonary tuberculomas simulating metastatic disease

Abstract

A 62-year-old lady presented with bilateral nodular lung opacities suspicious of metastatic disease on chest radiography and high-resolution CT. Histopathology, however, revealed caseating granulomas. The correct diagnosis of tuberculosis (TB) was confirmed when she responded clinically and radiologically to antitubercular treatment. TB should be considered in the differential diagnosis of bilateral nodular opacities which is the usual presentation of secondary malignancies of lung.

Pulmonary tuberculosis mimicking numerous lung metastases — a case study

“…Introduction of ethambutol was delayed in view of the need for an ophthalmological consultation, hence it was incorporated into the treatment management upon the 21st day, at the dose of 1250 mg/d. a manifestation of pulmonary tuberculosis is very rare, indeed (6)(7)(8)(9). It should nevertheless be always borne in mind that it is a potentially promising diagnostic avenue to be pursued, if only to save the patient going through a number of unnecessary, often invasive diagnostic procedures.…”

A Case of Pulmonary Tuberculosis Presenting as Multiple Nodular Opacities on a Chest X-Ray

“…Bilateral nodular lung opacities suspicious of metastatic disease on chest radiography and high-resolution CT scan have been found to be tubercular in various case studies. [ 8 9 ]…”

Posterior mediastinal mass diagnosed as schwanomma with concomittant tuberculosis

“…The postoperative X-ray of the chest posteroanterior view (figure 5) showed complete clearance. Since tuberculosis can present in any way as we have reported tuberculosis mimicking malignancy in two situations earlier also1 2 the excised tissue was also sent for culture and sensitivity for Mycobacterium tuberculosis by both bactec method and conventional Lowenstein–Jensen culture method and to our utmost surprise both showed growth of the M. tuberculosis which was sensitive to all first-line antitubercular therapy (ATT). The patient was initiated on standard four drugs ATT regimen and responded well to the treatment and was declared cured after 6 months of ATT (rifampicin, isoniazid, ethambutol and pyrazinamide (RHEZ)).…”