Multifocal tuberculosis simulating a cancer-a case report

Abstract

Background: Tuberculosis is a disease that may affect any organ of the body. Multifocal tuberculosis involving multiple systems with associated symptoms are rare, which makes the diagnosis challenging. Distinguishing multifocal tuberculosis from lesions metastatic from system malignancy is difficult. Single detection method is difficult to make a diagnosis. A combination of multiple methods is essential. Case presentation: A 17-year-old male presented with a 20 days weakness of lower limbs, which aggravated for 6 days. The PET/CT showed increased metabolism of ileocecal intestinal and terminal ileum wall, multiple enlarged lymph node (LNs), multiple osteolytic bone lesions, and soft tissue intensity belong T7 and T8 vertebrae. To confirm the diagnosis of the disease, a biopsy of the mediastinum lymph nodes was carried out. Polymerase chain reaction (PCR) test of the specimen was positive for the Mycobacterium tuberculosis, the T-SPOT and Xpert MTB/RIF test were also positive, which suggested the presence of Mycobacterium tuberculosis. The final diagnosis was multifocal tuberculosis, the patients received the resection of the mass in the spine. Anti-tuberculosis drugs were given. The myodynamia and muscle tension of the patients recovered following the therapy. Conclusions: Our results indicated that Multifocal tuberculosis should also be taken into consideration when lesions metastatic from system malignancy were suspected from images results even without the clinical symptoms of tuberculosis, and combination of multiple diagnosis methods were essential for the diagnosis of multifocal disease.

Solitary Chest Wall Tuberculosis Mimicking a Malignancy Demonstrated on FDG PET/CT

“…4,5 However, FDG PET/CT image of tuberculosis in various sites may be misdiagnosed as malignant tumor. [6][7][8][9] Wang et al 10 reported a case of primary chest wall tuberculosis presenting as intense FDG uptake in the posterior pleural mass and adjacent muscle without rib involvement mimicking a malignancy. The patient in our case had simultaneous rib, muscle, and diaphragm invasion.…”

“…FDG PET/CT has vital value in evaluating total disease burden and treatment response in tuberculosis patients 4,5 . However, FDG PET/CT image of tuberculosis in various sites may be misdiagnosed as malignant tumor 6–9 . Wang et al 10 reported a case of primary chest wall tuberculosis presenting as intense FDG uptake in the posterior pleural mass and adjacent muscle without rib involvement mimicking a malignancy.…”

68Ga-FAPI PET/CT Imaging of Multiple Muscle Metastases of Pancreatic Cancer

“…However, the results of 18 F-FDG PET/CT can be interpreted by malignancy or extrapulmonary tuberculosis. 1 FIGURE 2. 68 Ga-FAPI is a promising tracer for diagnostic imaging that is highly expressed in many malignant tumors.…”

“…However, CT showed no obvious changes in the shape of the pancreas and no definite abnormality in other abdominal organs. However, the results of 18 F-FDG PET/CT can be interpreted by malignancy or extrapulmonary tuberculosis 1 …”