A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature Review
Meng Hu Department of Oncology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, People’s Republic of ChinaCorrespondence: Meng Hu, Email 1258317002@qq.comBackground: Tuberculosis (TB) is a very common and easily diagnosed as a malign...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-12-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/a-case-of-multi-organ-tuberculosis-misdiagnosed-as-lung-cancer-and-a-l-peer-reviewed-fulltext-article-CMAR |
| _version_ | 1797373572847501312 |
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| author | Hu M |
| author_facet | Hu M |
| author_sort | Hu M |
| collection | DOAJ |
| description | Meng Hu Department of Oncology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, People’s Republic of ChinaCorrespondence: Meng Hu, Email 1258317002@qq.comBackground: Tuberculosis (TB) is a very common and easily diagnosed as a malignancy. However, studies have described the difference between TB and lung cancer. Single-organ TB and lung cancer are often easily distinguished clinically. Atypical systemic hematogenous disseminated TB (HDTB) is uncommon, including rare cases involving multiple organs such as cervical lymph nodes, pleura, liver, and lung TB simultaneously, which are more confusing and easily misdiagnosed in clinical practice.Case Presentation: A HIV-negative 56-year-old male was hospitalized for chest disease with main symptoms of chest tightness, chest pain, fatigue, anorexia, and weight loss. Heart rate 109 times/min, the computed tomography (CT) scans of the neck, chest, and abdomen revealed multiple nodules in the right pleura, right pleural encapsulated effusion, and limited, incomplete expansion of the middle and lower lobes of the right lung, enlarged lymph nodes in the right hilar and mediastinal and diaphragm groups, and multiple slightly low-density nodules in the liver, bone destruction in the 2nd thoracic vertebra, raising the possibility of multiple liver metastases of right lung cancer and malignant pleural fluid. The lymph nodes in the neck, mediastinum, abdomen, and pelvis were enlarged bilaterally. After comprehensive analysis, the patient was diagnosed with atypical systemic HDTB. After three months of conventional anti-TB treatment, the patient refused our hospital follow-up, and his symptoms improved significantly during the telephone follow-up.Conclusion: Most previous TB misdiagnoses involved a single organ, and this case enriches the clinical experience of diagnosing atypical HDTB. We encourage clinicians to establish a dynamic diagnostic and therapeutic mindset, emphasizing the value of biopsy and pathology.Keywords: tuberculosis, hepatic tuberculosis, pulmonary dysplasia, lung cancer, pathological diagnosis |
| first_indexed | 2024-03-08T18:51:25Z |
| format | Article |
| id | doaj.art-d536e382735d406a89f73166c32defa5 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-03-08T18:51:25Z |
| publishDate | 2023-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-d536e382735d406a89f73166c32defa52023-12-28T18:07:22ZengDove Medical PressCancer Management and Research1179-13222023-12-01Volume 151395140089317A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature ReviewHu MMeng Hu Department of Oncology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, People’s Republic of ChinaCorrespondence: Meng Hu, Email 1258317002@qq.comBackground: Tuberculosis (TB) is a very common and easily diagnosed as a malignancy. However, studies have described the difference between TB and lung cancer. Single-organ TB and lung cancer are often easily distinguished clinically. Atypical systemic hematogenous disseminated TB (HDTB) is uncommon, including rare cases involving multiple organs such as cervical lymph nodes, pleura, liver, and lung TB simultaneously, which are more confusing and easily misdiagnosed in clinical practice.Case Presentation: A HIV-negative 56-year-old male was hospitalized for chest disease with main symptoms of chest tightness, chest pain, fatigue, anorexia, and weight loss. Heart rate 109 times/min, the computed tomography (CT) scans of the neck, chest, and abdomen revealed multiple nodules in the right pleura, right pleural encapsulated effusion, and limited, incomplete expansion of the middle and lower lobes of the right lung, enlarged lymph nodes in the right hilar and mediastinal and diaphragm groups, and multiple slightly low-density nodules in the liver, bone destruction in the 2nd thoracic vertebra, raising the possibility of multiple liver metastases of right lung cancer and malignant pleural fluid. The lymph nodes in the neck, mediastinum, abdomen, and pelvis were enlarged bilaterally. After comprehensive analysis, the patient was diagnosed with atypical systemic HDTB. After three months of conventional anti-TB treatment, the patient refused our hospital follow-up, and his symptoms improved significantly during the telephone follow-up.Conclusion: Most previous TB misdiagnoses involved a single organ, and this case enriches the clinical experience of diagnosing atypical HDTB. We encourage clinicians to establish a dynamic diagnostic and therapeutic mindset, emphasizing the value of biopsy and pathology.Keywords: tuberculosis, hepatic tuberculosis, pulmonary dysplasia, lung cancer, pathological diagnosishttps://www.dovepress.com/a-case-of-multi-organ-tuberculosis-misdiagnosed-as-lung-cancer-and-a-l-peer-reviewed-fulltext-article-CMARtuberculosishepatic tuberculosispulmonary dysplasialung cancer；pathological diagnosis |
| spellingShingle | Hu M A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature Review Cancer Management and Research tuberculosis hepatic tuberculosis pulmonary dysplasia lung cancer；pathological diagnosis |
| title | A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature Review |
| title_full | A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature Review |
| title_fullStr | A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature Review |
| title_full_unstemmed | A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature Review |
| title_short | A Case of Multi-Organ Tuberculosis Misdiagnosed as Lung Cancer and a Literature Review |
| title_sort | case of multi organ tuberculosis misdiagnosed as lung cancer and a literature review |
| topic | tuberculosis hepatic tuberculosis pulmonary dysplasia lung cancer；pathological diagnosis |
| url | https://www.dovepress.com/a-case-of-multi-organ-tuberculosis-misdiagnosed-as-lung-cancer-and-a-l-peer-reviewed-fulltext-article-CMAR |
| work_keys_str_mv | AT hum acaseofmultiorgantuberculosismisdiagnosedaslungcancerandaliteraturereview AT hum caseofmultiorgantuberculosismisdiagnosedaslungcancerandaliteraturereview |