Diagnostic Difficulty in Pseudotumoral Form of Pulmonary Tuberculosis: A New Case

Abstract

The pseudotumoral form of tuberculosis is rare in healthy immunocompetent patients. This form can mimic benign and malignant tumors. The diagnosis is confirmed by bacteriological and/or different histological samples. In this specific case, the patient presented with cough, left chest pain, fatigue and fever. The chest computerized tomography (CT) scan revealed an inhomogeneous mass that initially appeared to be a primary tumor. However, further investigation was required to establish an accurate diagnosis. Histopathological examination of the biopsy samples obtained through bronchoscopy did not indicate any evidence of neoplasia. Bronchoalveolar lavage (BAL) was positive for Mycobacterium tuberculosis, and real-time PCR for detecting M. tuberculosis was positive. Two transparietal punctures were performed and histological analysis revealed nonspecific inflammation. Pulmonary TB was diagnosed and a therapeutic regimen was prescribed with good clinical, biological and radiological improvement. This case emphasizes the diagnostic challenges associated with the pseudotumoral form of tuberculosis. It highlights the importance of considering tuberculosis in the differential diagnosis, even when the radiographic images and clinical history suggest an alternative diagnosis, particularly in areas where tuberculosis is endemic.