Parita Soni, Vivek Kumar, Stephan Kamholz, William Pascal, Yizhak Kupfer
Maimonides Medical Center, Brooklyn, NY, USA.
J Investig Med High Impact Case Rep. 2017 Jul 6;5(3):2324709617717540. doi: 10.1177/2324709617717540. eCollection 2017 Jul-Sep.
Infliximab therapy is associated with higher rates of active tuberculosis (TB), particularly extrapulmonary and disseminated forms with unusual symptoms. We report the case of a 66-year-old man with Crohn's disease who developed TB mimicking lung cancer on imaging. He presented with cough and fever of 2 weeks' duration shortly after starting infliximab. Computed tomography of the chest revealed a 7.0 × 3.2 cm pleural-based mass, highly suspicious for malignancy. Histopathological examination confirmed the diagnosis of TB. The mass disappeared after antitubercular treatment, and the patient recovered completely. A review of the literature suggests that TB masquerades as lung cancer clinically and radiologically. The classical lesions of TB are cavitatory with calcifications. Mass lesions without cavity or calcifications are rare and are mostly reported from regions endemic for TB. The majority of patients on infliximab therapy required biopsy for accurate diagnosis of TB because of its unusual presentation.
英夫利昔单抗治疗与活动性结核病（TB）的高发病率相关，尤其是肺外和播散型结核病，伴有不寻常的症状。我们报告了一例66岁克罗恩病男性患者，其在影像学上表现为类似肺癌的结核病。他在开始使用英夫利昔单抗后不久出现了持续2周的咳嗽和发热。胸部计算机断层扫描显示一个7.0×3.2厘米的胸膜肿块，高度怀疑为恶性肿瘤。组织病理学检查确诊为结核病。抗结核治疗后肿块消失，患者完全康复。文献综述表明，结核病在临床和放射学上可伪装成肺癌。结核病的典型病变为有空洞并伴有钙化。无空洞或钙化的肿块病变很少见，大多报道于结核病流行地区。由于英夫利昔单抗治疗的患者结核病表现不寻常，大多数患者需要进行活检以准确诊断结核病。
