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表现为前纵隔肿块的结核病:病例报告

Tuberculosis presenting as Anterior Mediastinal Mass: A Case Report.

作者信息

Pradhan Simran, Khadka Image

机构信息

National Open College, Lalitpur, Nepal.

Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2024 Feb 29;62(271):220-222. doi: 10.31729/jnma.8508.

Abstract

The mediastinum, located between the pleural sacs, has three compartments. The anterior mediastinum spans anteriorly from the sternum to the pericardium and brachiocephalic vessels posteriorly. Common lesions in this area include thymomas, lymphomas, teratomatous neoplasms, and thyroid masses. A mediastinal mass in the setting of tuberculous meningoencephalitis is an uncommon presentation of tuberculosis. We present a case of a 20-year-old girl with fever and headache diagnosed with tuberculous meningoencephalitis. A thorough workup revealed an anterior mediastinal mass, histopathologically diagnosed as tubercular in origin. Treatment involved surgery and antituberculosis therapy. Tuberculosis can manifest uniquely, and an isolated mediastinal mass, especially in an immunocompetent individual, is unusual. Treatment typically involves a combination of antimicrobial medications, and in some cases, surgical intervention may be necessary to address complications or persistent masses. This case emphasizes the importance of considering tuberculosis as a diagnosis when a patient presents with a mass in the anterior mediastinum.

摘要

纵隔位于胸膜囊之间,分为三个腔室。前纵隔向前起自胸骨,向后至心包和头臂血管。该区域常见的病变包括胸腺瘤、淋巴瘤、畸胎瘤和甲状腺肿物。结核性脑膜脑炎患者出现纵隔肿物是结核病的一种罕见表现。我们报告一例20岁发热、头痛的女孩,诊断为结核性脑膜脑炎。全面检查发现前纵隔肿物,组织病理学诊断为结核起源。治疗包括手术和抗结核治疗。结核病可表现独特,孤立的纵隔肿物,尤其是在免疫功能正常的个体中并不常见。治疗通常需要联合使用抗菌药物,在某些情况下,可能需要手术干预以处理并发症或持续性肿物。该病例强调了在前纵隔肿物患者中考虑结核病诊断的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9511/10924477/8bcd28ca8617/JNMA-62-271-220-g1.jpg

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