Yeungnam Univ J Med.  2015 Jun;32(1):50-54. 10.12701/yujm.2015.32.1.50.

Malignant mesothelioma mistaken for tuberculous pleurisy

• Yang JY
• Song MJ
• Park SJ
• Cheon J
• Yoo JW
• Choi CM
• Kim YH

• KMID: 2138645
• DOI: http://doi.org/10.12701/yujm.2015.32.1.50

Abstract

Malignant mesothelioma is a common, primary tumor that can invade pleura, and is associated with previous exposure to asbestos. However, it poses considerable difficulties regarding its diagnosis and treatment, and thus, accurate history taking with respect to exposure to asbestos, and radiologic and pathologic examinations are essential. In addition, the involvement of a multidisciplinary team is recommended in order to ensure prompt and appropriate management using a framework based on radiotherapy, chemotherapy, surgery, and symptom palliation with end-of-life care. Because lymphocyte-dominant, exudative pleural effusion can occur in malignant mesothelioma, adenosine deaminase values may be elevated, which could be mistaken for tuberculous pleurisy, and lead to an incorrect diagnosis and suboptimal treatment. The authors describe a case of malignant mesothelioma initially misdiagnosed as tuberculous pleurisy. As evidenced by the described case, malignant mesothelioma should be considered during the differential diagnosis of patients with lymphocyte-dominant, exudative pleural effusion with a pleural lung lesion.

Keyword

Malignant mesothelioma; Adenosine deaminase; Pleural tuberculosis

MeSH Terms

Adenosine Deaminase
Asbestos
Diagnosis
Diagnosis, Differential
Drug Therapy
Humans
Lung
Mesothelioma*
Pleura
Pleural Effusion
Radiotherapy
Tuberculosis, Pleural*
Adenosine Deaminase
Asbestos