1st International Military Congress of Tropical Medicine and Sub-Saharan Diseases (Gabès, 2016)

Pseudo-tumoral pulmonary tuberculosis in immunocompetent adult

Pan African Medical Journal - Conference Proceedings. 2017:4(154).05 Dec 2017.
doi: 10.11604/pamj-cp.2017.4.154.362

Archived on: 05 Dec 2017

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Keywords: Tuberculosis, pseudotumor, pseudo-tumoral tuberculosis

Abstract

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Pseudo-tumoral pulmonary tuberculosis in immunocompetent adult

Nesrine Belgacem^1,&, Najla Lassoued¹, Hassène Baïli¹, Safa Trabelsi¹, Maher Béji¹, Salem Bouomrani¹

¹Department of Internal Medicine, Gabès Military Hospital, Gabès, Tunisia

^&Corresponding author
Nesrine Belgacem, Department of Internal Medicine, Gabès Military Hospital, Gabès, Tunisia

Abstract

Introduction: the pseudo-tumoral form of tuberculosis is exceptional, it accounts for only 1 to 5% of the pulmonary tuberculosis. Because it simulates lung carcinoma, diagnosis can be delayed and lead to abusive surgical resection.

Methods: 23-year-old Tunisian immunocompetent adult without pathological history was explored for trailing fever, cough and thoracic pains not improved by the symptomatic treatment. The somatic examination found a feverish patient with 38.5°C. Biology revealed a marked inflammatory syndrome. Chest X-ray showed a round parenchymal masse of the right upper lobe. The patient was treated like having a bacterial pneumonia but without improvement. Lung CT scan objectified a well limited parenchymal masse occupying the entire right upper lobe with annular catch of contrast.

Results: tumor markers were normal. Bronchoscopic examination was normal without neoplasic cells on the aspiration. Direct exam for mycobacterium tuberculosis was negative. Transbronchial lung biopsy showed granulomas with caseation and Langhans giant cells. Under anti-tubercular therapy, the evolution was favorable with disappearance of the functional complaints and sub-total radiological clearing at the end of a few weeks.

Conclusion: this particular form of pulmonary tuberculosis deserves to be known especially in a country like ours where tuberculosis remains endemic.