Snene H, Ben Mansour A, Toujani S, Ben Salah N, Mjid M, Ouahchi Y, Mehiri N, Beji M, Cherif J, Louzir B
Université de Tunis El Manar, faculté de Médecine de Tunis, CHU Mongi Slim, service de pneumologie allergologie (unité de recherche 12SP06), La Marsa, Tunisie.
Université de Tunis El Manar, faculté de médecine de Tunis, CHU La Rabta, service de pneumologie allergologie (unité de recherche 12SP06), Tunis, Tunisie.
Rev Mal Respir. 2018 Mar;35(3):295-304. doi: 10.1016/j.rmr.2017.03.038. Epub 2018 Apr 5.
The pseudotumorous form of tuberculosis is a rare entity. Whatever its location, it can simulate neoplasia by its radiological and/or endoscopic appearances. We highlight the diagnostic difficulties associated with this type of presentation.
We performed a retrospective study of inpatient records from 2003 to 2016 in the pneumology department of La Rabta Hospital to identify cases of thoracic tuberculous pseudo-tumor.
Seventeen patients were identified. The median age was 41 years and their symptomatology was dominated by cough and general debility. All had abnormal radiology with 10 cases of suspect lesions. Fibre-optic bronchoscopy revealed endobronchial abnormalities in 11 cases. The median overall diagnostic delay was 97 days. The diagnosis was confirmed bacteriologically in five cases, histologically in 14 cases and based on clinical presumption in one case. The progression was favourable: 13 patients have been declared cured and four patients are still undergoing treatment.
Making a positive diagnosis of thoracic tuberculous pseudotumour can be difficult, as bacteriological samples are often negative. This can lead to a significant delay in diagnosis and treatment.
结核的假瘤样形式是一种罕见的情况。无论其位于何处，它都可以通过其放射学和/或内镜表现模拟肿瘤。我们强调了与这种表现类型相关的诊断困难。
我们对拉巴特医院呼吸科2003年至2016年的住院记录进行了回顾性研究，以确定胸内结核假瘤病例。
共确定了17例患者。中位年龄为41岁，其症状以咳嗽和全身虚弱为主。所有患者的放射学检查均异常，其中10例有可疑病变。纤维支气管镜检查显示11例有支气管内异常。总体诊断中位延迟时间为97天。5例经细菌学确诊，14例经组织学确诊，1例基于临床推测确诊。病情进展良好：13例患者已宣布治愈，4例仍在接受治疗。
胸内结核假瘤的阳性诊断可能很困难，因为细菌学样本往往为阴性。这可能导致诊断和治疗的显著延迟。
