Pitlik S D, Fainstein V, Bodey G P
Am J Med. 1984 May;76(5):822-5. doi: 10.1016/0002-9343(84)90993-8.
The charts of 26 patients who were referred with a presumptive diagnosis of neoplasms and who were ultimately found to have only tuberculosis were reviewed. Twenty-one patients (81 percent) were born in the United States, and only three patients had a history of exposure to tuberculosis. Most patients had few symptoms, and the average duration of symptoms was 2.8 +/- 1.5 months. Classic symptoms of tuberculosis, like fever, hemoptysis, and weight loss, were uncommon. Chest roentgenographic abnormalities were present in 62 percent of the patients. Although some of the patients had undergone nondiagnostic biopsy procedures before referral, none had had skin tests for tuberculosis. Underlying conditions were found in eight patients, and alcoholism was the most common. Laboratory abnormalities were rare with the exception of increased platelet counts, which were found in eight patients. The most common form of tuberculosis was pulmonary (14 patients) followed by lymphadenitis (nine patients). Tuberculosis remains an elusive disease even in countries with advanced medical technology. In some cases, its presentation may suggest the presence of malignancy.
对26例最初被诊断为肿瘤但最终仅确诊为结核病的患者病历进行了回顾。21例患者（81%）出生于美国，仅有3例有结核接触史。大多数患者症状轻微，症状平均持续时间为2.8±1.5个月。发热、咯血和体重减轻等典型结核症状并不常见。62%的患者胸部X线检查有异常。尽管部分患者在转诊前接受过非诊断性活检，但均未进行结核菌素皮肤试验。8例患者有基础疾病，其中酗酒最为常见。除8例患者血小板计数升高外，实验室检查异常少见。最常见的结核类型为肺结核（14例），其次为淋巴结炎（9例）。即使在医疗技术发达的国家，结核病仍然难以捉摸。在某些情况下，其表现可能提示恶性肿瘤的存在。
