Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Department of Pathology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Int J Mycobacteriol. 2021 Jul-Sep;10(3):327-329. doi: 10.4103/ijmy.ijmy_89_21.
Mycobacterium tuberculosis infection (TB) masquerading as lung tumor is well reported, but its mimicry as metastatic thoracic cancer is rare. We report the case of a young male who presented with clinical and radiological picture of lung cancer but investigations confirmed it as TB. A 35-year-old male, with 18-pack year of smoking history, presented with dry cough, anorexia, weight loss, and lower back and left hip pain. Chest imaging showed right upper lobe speculated mass with mediastinal and hilar lymphadenopathy and a lytic lesion in the left sacral area. Magnetic resonance imaging of the spine and pelvis revealed lytic lesion in the left sacrum. Fluorodeoxyglucose positron emission tomography computed tomography scan of the whole body showed hypermetabolic lung lesion with ipsilateral mediastinal, supraclavicular, splenic, and bone metastasis in the left aspect of the sacrum. Computed tomography (CT)-guided biopsy of the lung lesion showed necrotizing granuloma and tissue culture was positive for pan-susceptible M. tuberculosis. Follow-up CT scan showed complete resolution of the lung lesion and lymph nodes after anti-TB treatment with significant reduction in the sacral lesion. Mycobacterial infection may mimic metastatic lung cancer and should always be considered a differential diagnosis.
结核分枝杆菌感染（TB）伪装为肺部肿瘤已有大量报道，但将其伪装为转移性胸癌则较为罕见。我们报告了一例年轻男性，其临床表现和影像学表现均为肺癌，但经检查确诊为 TB。
一名 35 岁男性，有 18 包/年的吸烟史，出现干咳、食欲不振、体重减轻以及腰背部和左髋部疼痛。胸部影像学显示右上叶有斑片状肿块，伴纵隔和肺门淋巴结肿大以及左侧骶骨溶骨性病变。脊柱和骨盆的磁共振成像显示左侧骶骨有溶骨性病变。全身氟脱氧葡萄糖正电子发射断层扫描计算机断层扫描显示右侧肺病变呈高代谢，同侧纵隔、锁骨上、脾脏和左侧骶骨有骨转移。对肺部病变进行 CT 引导活检显示坏死性肉芽肿，组织培养对全敏结核分枝杆菌呈阳性。抗结核治疗后，肺部病变和淋巴结完全消退，骶骨病变显著缩小。分枝杆菌感染可能会模仿转移性肺癌，应始终作为鉴别诊断的考虑因素。
