Cancer or Tuberculosis: A Comprehensive Review of the Clinical and Imaging Features in Diagnosis of the Confusing Mass

Abstract

Confusing masses constitute a challenging clinical problem for differentiating between cancer and tuberculosis diagnoses. This review summarizes the major theories designed to identify factors associated with misdiagnosis, such as imaging features, laboratory tests, and clinical characteristics. Then, the clinical experiences regarding the misdiagnosis of cancer and tuberculosis are summarized. Finally, the main diagnostic points and differential diagnostic criteria are explored, and the characteristics of multimodal imaging and radiomics are summarized.

Necrotizing granulomatous inflammation mimicking skeletal metastasis: a possible differential diagnosis

“…Tuberculosis and malignancy are risk factors for each other, and coexistence of tuberculosis in such cases cannot be ignored (Chen et al 2021;Nanthanangkul et al 2020). Also, the radiological appearances of tuberculosis and malignancy are very similar, thus increasing the confusion for diagnosis (Xiang et al 2021). Pott's spine is a known common differential for lytic skeletal metastases (Liu et al 2017;Ye et al 2016;Go et al 2012), and nonspecific uptake of F-18 FDG in active infection and inflammation reduces its specificity.…”

Tuberculosis-Specific Antigen/Phytohemagglutinin Ratio Combined With GeneXpert MTB/RIF for Early Diagnosis of Spinal Tuberculosis: A Prospective Cohort Study

“…The various diagnostic methods of spinal TB have their advantages and disadvantages. The imaging presentation of spinal TB is highly consistent with other infections and spinal metastatic adenocarcinoma (Xiang et al, 2021). For inflammatory parameters, the elevation in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) has indications but with relatively low specificity (Ryu and Patel, 2015).…”

Tuberculosis in pregnancy

“…As TB disease can present as acute lower respiratory tract infection and community-acquired pneumonia with transient improvement following antibiotic treatment, the threshold for screening should be lowered in these women [ 56 , 57 ]. Other rare but important differential diagnoses of pregnant women that can mimic TB or vice versa include gestational trophoblastic disease with lung metastasis and lung cancer [ 58 , 59 ].…”