Pseudotumoral form of primary progressive tuberculosis<FONT FACE=Symbol></FONT>: a diagnosis to be considered

Abstract

The diversity of clinical presentations of primary progressive tuberculosis (TB) and the difficulty in establishing the diagnosis of paucibacillary forms is the subject of painstaking research, as well as a cause of delay in therapy. We report the case of a 10-year-old black child who presented with chest pain and progressive widening of the upper mediastinum. Computerized tomography of the chest revealed multiple calcifications that were not identified with X-rays. Biopsy through mediastinoscopy was compatible with a diagnosis of tuberculosis. Despite exhaustive investigation that included direct examination, culture for mycobacteria and PCR (Polymerase Chain Reaction) of tissue samples, the etiologic agent was not revealed. Tuberculin conversion was observed during the follow-up and resolution period of the lesion, after administration of isoniazid, rifampicin and pyrazinamide. The nodal pseudotumoral form of tuberculosis is rare in immunocompetent children and it may simulate neoplastic disease; therefore, it should be included in the list of differential diagnoses of masses located in the anterosuperior mediastinum.

Obstructive Pseudotumor of Tuberculosis in a Young Woman: A Rare Presentation

“…The pseudotumors of tuberculosis have mostly been reported in mediastinum [3, 6, 7]; sometimes, tuberculosis can present as a mass lesion at liver hilum that is diagnosed by surgery [6]. In spite of imaging advances, diagnosis of this pseudotumor is finally made by surgery or sampling [8, 12].…”

“…Pseudotumor of abdomen is a rare and distinct clinical entity. In fact extrapulmonary tuberculosis is rare and retroperitoneal mass is extremely rare manifestation of extrathoracic tuberculosis [1, 3–6]. Inflammatory pseudotumor occurs because of diverse processes including infective or reactive/reparative processes or low grade mesenchymal malignancy [7].…”

Tendência da mortalidade por tuberculose no Brasil, 1980 a 2004

“…17 In deaths due to pulmonary neoplasias and chronic lower pulmonary diseases showing TB as associated cause, TB may have caused delayed diagnosis or misdiagnosis and negatively affected the outcome. 9 Clinical cohort or case studies could provide input to support this hypothesis.…”

A case of pulmonary tuberculosis presenting as a large pseudo-tumour

“…The pseudo-tumours of tuberculosis are uncommon manifestation of the disease and they have mostly been reported in gastrointestinal system, mediastinum and brain [11][12][13][14] .…”