Ann Clin Microbiol.  2017 Mar;20(1):17-20. 10.5145/ACM.2017.20.1.17.

Tuberculosis Presenting as a Mediastinal Mass in an Infant

• Kim N
• Lee HJ
• Yi J
• Park SE
• Chang CL

• KMID: 2373001
• DOI: http://doi.org/10.5145/ACM.2017.20.1.17

Abstract

Tuberculosis can occur in various organ systems and may present with diverse manifestations. We report an unusual case of mediastinal tuberculoma in a 3-month-old boy who presented to the hospital after experiencing fever, cough, and progressive pneumonia for two weeks. The chest computed tomography scan indicated a mediastinal mass suggesting lymphoma. However, histological analysis confirmed that the mass was caused by tuberculosis. The present report describes the delayed diagnosis of a disease due to an uncommon presentation. Misdiagnosing unusual cases of tuberculosis results in treatment delays and may lead to an increase in morbidity. Therefore, we suggest that tuberculosis should be included in the differential diagnosis for children presenting with a mediastinal mass, especially in areas with a high prevalence of tuberculosis.

Keyword

Lymphoma; Mediastinum; Mass; Tuberculosis

MeSH Terms

Child
Cough
Delayed Diagnosis
Diagnosis, Differential
Fever
Humans
Infant*
Lymphoma
Male
Mediastinum
Pneumonia
Prevalence
Thorax
Tuberculoma
Tuberculosis*

Figure

• 

  Fig. 1 Radiological findings of the patient. (A) The plain chest radiograph taken upon admission showed haziness in both lungs. (B) The initial chest CT scan showed a large mediastinal mass compressing the main bronchus.

• 

  Fig. 2 Histopathological findings of the surgical specimens. (A) The permanent section showed chronic granulomatous inflammation and necrosis compatible with tuberculosis infection (hematoxylin and eosin stain, ×40). (B) The surgical specimens showed acid-fast bacilli (Ziehl-Neelsen staining, ×1,000). (C) The purulent material from the inside of mass showed acid-fast bacilli (Ziehl-Neelsen staining, ×1,000).

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