Invasive Lung Adenocarcinoma Mimicking Nodular Tuberculosis in a HIV Positive Patient (Case report)

Abstract

Even though there are many similarities in symptoms and radiological aspect between pulmonary tuberculosis (TB) and lung neoplasia, there are many differences between them like different etiologies, different consequences, and altogether different management. We present a case of a 59 years old male, heterosexual, who was HIV diagnosed in the last 16 years. He had a good immunological and virusological evolution over the time. In the last 5 months of his life he was diagnosed with pulmonary TB and he received specific treatment. After 4 months of antituberculous treatment patient became asthenic, febrile, with productive cough, and weight loss. Imagistic evolution was unfavorable. The suspicion of pulmonary neoplasm raises in the last 3 weeks of his life. Macroscopic lung examination during autopsy was suggestive rather to a pulmonary TB than a lung neoplasm, with a nodular pattern very similar with nodular TB. Histopathological examination evidenced a lung adenocarcinoma. In HIV patients a delayed or missed diagnosis of lung cancer, can lead to late treatment or wrong treatments, and finally death of patient.

Human cytomegalovirus in cancer: the mechanism of HCMV-induced carcinogenesis and its therapeutic potential

“…In this study, mice at the age of 2 days were infected with murine CMV and 43% of infected mice develop smooth muscle tumors by the age of 9 months (Price et al, 2012). A case study has shown that an AIDS patient with pulmonary inflammatory myofibroblastic tumor (PIMT) had CMV as confirmed by a serological study on the tumor tissue suggesting a role of CMV in this type of tumor (Cambrea et al, 2014). Serological tests were negative for mycoplasma and Epstein-Barr virus (EBV).…”