Pseudotumoural pulmonary tuberculosis: a case series

Abstract

This report describes three cases of tumour-like pulmonary tuberculosis: two patients had stage C3 human immunodeficiency virus (HIV) infection (with uncontrolled HIV-1 in one case) and one patient was immunocompetent. All patients initially presented with general and respiratory symptoms, with radiological findings simulating lung carcinoma. Tuberculosis was diagnosed from microbiological testing and/or histological examination results. A disseminated form was described in one case. All patients were treated successfully with antimycobacterial therapy, with control of HIV infection in both cases.

Keywords: Efavirenz; Human immunodeficiency virus; Lung carcinoma; Pseudotumoural; Pulmonary mass; Tuberculosis.

Figure 1

Chest computed tomography image [axial lung window (1A) and axial mediastinal window (1B)] showing a large right posterior mediastinal mass with coarse boundary, associated with mediastinal necrotic lymphadenopathy, without peripheral consolidation or pleural effusion.

Figure 2

Posteroanterior chest radiograph (2A) showing irregular opacity projecting over the right lower lobe, and confirmed in the chest computed tomography axial parenchymal window (2B). This showed the presence of a right lower lobe pulmonary mass with central excavation associated with multiple bilateral nodules.

Figure 3

Chest computed tomography (3A) showing a spiculated left upper lobe pulmonary mass with ground‐glass opacities, alveolar consolidation in linear atelectasis and multiple nodules. Abdominal computed tomography (3B) showed hepatomegaly (17 cm) with an enlarged spleen (13 cm) and multiple low-density nodules.