Khurana Shruti, Chhoda Ankit, Sahay Sandeep, Pathania Priyanka
. Lady Hardinge Medical College, New Delhi, India.
. Maulana Azad Medical College, Department of Internal Medicine, New Delhi, India.
J Bras Pneumol. 2017 Jul-Aug;43(4):320-321. doi: 10.1590/S1806-37562015000000269.
We describe the case of a 33-year-old man, a chronic user of powder cocaine, who presented with dyspnea, fever, night sweats, and significant weight loss. Chest HRCT revealed centrilobular nodules, giving an initial impression of miliary tuberculosis. Therefore, he was started on an empirical, four-drug antituberculosis treatment regimen. Four weeks later, despite the tuberculosis treatment, he continued to have the same symptoms. We then performed transbronchial lung biopsy. Histopathological analysis of the biopsy sample revealed birefringent foreign body granuloma. A corroborative history of cocaine snorting, the presence of centrilobular nodules, and the foreign body-related histopathological findings led to a diagnosis of pulmonary foreign body granulomatosis. This report underscores the fact that pulmonary foreign body granulomatosis should be included in the differential diagnosis of clinical profiles resembling tuberculosis.
我们描述了一名33岁男性的病例，该患者长期使用可卡因粉末，出现呼吸困难、发热、盗汗及显著体重减轻。胸部高分辨率CT（HRCT）显示小叶中心结节，初步印象为粟粒性肺结核。因此，他开始接受经验性的四联抗结核治疗方案。四周后，尽管接受了抗结核治疗，他仍有相同症状。然后我们进行了经支气管肺活检。活检样本的组织病理学分析显示双折射异物肉芽肿。有吸食可卡因的相关病史、小叶中心结节的存在以及与异物相关的组织病理学发现，最终诊断为肺异物肉芽肿病。本报告强调了一个事实，即在鉴别诊断类似结核病的临床症状时应考虑肺异物肉芽肿病。
