Thu Myint B, Lwin Ni Ni, Hlaing Wut Y, Aung Norah H, Ikuine Tomoko
Internal Medicine, NYC Health + Hospitals/Harlem, New York, USA.
Internal Medicine, University of Medicine (1) Yangon, Yangon, MMR.
Cureus. 2025 Aug 26;17(8):e91060. doi: 10.7759/cureus.91060. eCollection 2025 Aug.
We report a case of disseminated tuberculosis (TB) manifesting as a soft tissue mass of the back associated with pain and difficulty walking. Its clinical presentation poses diagnostic challenges and can sometimes mimic neoplasms. The first imaging study with computed tomography was suggestive of metastatic bone disease or locally advanced malignancy. Advanced imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT), are required to evaluate the extent of organ involvement. A definitive diagnosis necessitates histopathological analysis and microbiological confirmation through acid-fast Bacilli staining and polymerase chain reaction (PCR) testing for (MTB). Disseminated TB is rare in immunocompetent patients, which accounts for <2% of all TB cases. It usually occurs from progressive primary infection or the reactivation of latent infection focus through lymphohematogenous spread. The risk of communicable diseases has increased due to recent migration, so it is important to investigate MTB in patients with unusual presentations, especially for people from endemic areas.
我们报告一例播散性结核病（TB），表现为背部软组织肿块，伴有疼痛和行走困难。其临床表现带来了诊断挑战，有时可酷似肿瘤。首次计算机断层扫描成像提示为转移性骨病或局部晚期恶性肿瘤。需要进行高级成像研究，如磁共振成像（MRI）或计算机断层扫描（CT），以评估器官受累程度。明确诊断需要通过抗酸杆菌染色和结核分枝杆菌（MTB）聚合酶链反应（PCR）检测进行组织病理学分析和微生物学确认。播散性结核病在免疫功能正常的患者中很少见，占所有结核病病例的不到2%。它通常由进行性原发性感染或潜伏感染灶通过淋巴血行播散重新激活引起。由于近期移民，传染病风险增加，因此对表现异常的患者，尤其是来自流行地区的患者进行MTB调查很重要。
