Abstract
Pulmonary tuberculosis PT is generally easily recognized by its classic features. Nevertheless, the radiological setting could be misleading, suggesting other diagnoses. We report 51 cases of PT with unusual in appearance and site (pseudotumoral 14 cases, endobronchial 25 cases, basal 8 cases and balloon release 4 cases). It occurred in 30 males and 21 females with a mean age of 40 years old (range age 15-71 years old). Twenty males were smokers. The clinical setting was dominated by bronchial syndrome, chest pain and haemoptysis. Chest X-ray showed pulmonary opacities-like tumor in 14 cases, retractable opacities in 20 cases, enlarged mediastinal lymph node in 5 cases, basal excavated opacities in 10 cases and a balloon release in 4 cases. Bronchoscopy showed endobronchial granulomas in 15 cases, bud-like tumor in 8 cases and mediastinal lymph node fistula in a bronchus in 2 cases. Chest scan highlighted a peripheral tumor-like process in 6 cases and a balloon release in 4 cases. The diagnosis of PT was confirmed by bacilloscopy in bronchial aspirate in 26 cases, bronchial biopsy in 20 cases, transmural biopsy in 6 cases, biopsy under thoracoscopy in 4 cases and an open surgical biopsy in 3 cases. Under antibacillary therapy, the evolution was favorable in all the cases. Despite their rarity, unusual forms of tuberculosis should be better known as it could simulate cancer especially in its particular pseudotumoral form.
- © 2011 ERS
