Tuberc Respir Dis.  2007 Aug;63(2):173-177. 10.4046/trd.2007.63.2.173.

A Case of Multifocal Tuberculosis Mimicking Metastatic Malignancy

• Cho IJ
• Im SY
• Chun EM
• Ryu YJ
• Lee JH
• Sim YS
• Jang JH
• Shim SS
• Bae JH

• KMID: 1910096
• DOI: http://doi.org/10.4046/trd.2007.63.2.173

Abstract

Tuberculosis remains as a major public health problem worldwide. In addition to classic pulmonary tuberculosis, tuberculosis may sometimes present atypically. In the case of atypical tuberculosis, the unusual sites and properties that mimic other diseases can lead to a misdiagnosis and therapeutic delay. Abdominal and pharyngeal tuberculosis are uncommon extrapulmonary manifestations of tuberculosis. To the best of our knowledge, a combination of abdominal and pharyngeal tuberculosis with endobronchial tuberculosis has not been reported. We report a case of concurrent abdominal and pharyngeal tuberculosis in a patient with chronic endobronchial tuberculosis mimicking a metastatic malignancy on computed tomography and FDG-PET.

Keyword

Tuberculosis; Neoplasm metastasis; Positron-Emission Tomography(PET)

MeSH Terms

Diagnostic Errors
Humans
Neoplasm Metastasis
Public Health
Tuberculosis*
Tuberculosis, Pulmonary

Figure

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  Figure 1 Chest CT scan obtained at admission shows a heterogenous low attenuated mass lesion with calcification(arrow).

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  Figure 2 Abdomen and pelvic CT scan shows a heterogenous low density mass lesion with calcification(arrow).

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  Figure 3 FDG-PET shows hypermetabolic masses at left nasopharynx(arrow), pelvic cavity(arrowhead) and left lower lung(black arrow). Standardized uptake values(SUVs) of nasopharynx, pelvic cavity and left lower lung are 7.1, 4.1 and 3.1, respectively.

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  Figure 4 Neck CT scan shows rim-enhancing low density lesions at left nasopharyx and oropharynx (black arrow).

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  Figure 5 Bronchoscopy shows an endobronchial mass covered with transparent membrane obstructing bronchus.

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  Figure 6 Chronic granulomatous inflammation with caseation necrosis is seen on this section obtained from pharynx. (H&E ×400)

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