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Cho, Im, Chun, Ryu, Lee, Sim, Jang, Shim, and Bae: A Case of Multifocal Tuberculosis Mimicking Metastatic Malignancy
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(2): 173-177.

Published online: 31 August 2007

DOI: https://doi.org/10.4046/trd.2007.63.2.173

A Case of Multifocal Tuberculosis Mimicking Metastatic Malignancy

In Jeong Cho, M.D.1, So Yeon Im, M.D.1, Eun Mi Chun, M.D.1, Yon Ju Ryu, M.D.1, Jin Hwa Lee, M.D.1, Yun Su Sim, M.D.1, Jung Hyun Jang, M.D.1, Sung Shin Shim, M.D.2, Jung Ho Bae, M.D.3

1Department of Internal Medicine, Dongdaemun Hospital, Ewha Womans University, School of Medicine, Seoul, Korea.

2Department of Radiology, Dongdaemun Hospital, Ewha Womans University, School of Medicine, Seoul, Korea.

3Department of Otorhinolaryngology, Dongdaemun Hospital, Ewha Womans University, School of Medicine, Seoul, Korea.

Address for correspondence: Eun Mi Chun, M.D. Department of Internal Medicine, Dongdaemun Hospital, Ewha Womans University, College of Medicine, Jongno 6-ga, Jongno-gu, Seoul, Korea. Phone: 82-2-760-5053, Fax: 82-2-762-7756, cem@ewha.ac.kr

Received 3 May 2007       Accepted 4 July 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Tuberculosis remains as a major public health problem worldwide. In addition to classic pulmonary tuberculosis, tuberculosis may sometimes present atypically. In the case of atypical tuberculosis, the unusual sites and properties that mimic other diseases can lead to a misdiagnosis and therapeutic delay. Abdominal and pharyngeal tuberculosis are uncommon extrapulmonary manifestations of tuberculosis. To the best of our knowledge, a combination of abdominal and pharyngeal tuberculosis with endobronchial tuberculosis has not been reported. We report a case of concurrent abdominal and pharyngeal tuberculosis in a patient with chronic endobronchial tuberculosis mimicking a metastatic malignancy on computed tomography and FDG-PET.

Keywords: Tuberculosis, Neoplasm metastasis, Positron-Emission Tomography(PET)

Figures and Tables

Figure 1
Chest CT scan obtained at admission shows a heterogenous low attenuated mass lesion with calcification(arrow).
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Figure 2
Abdomen and pelvic CT scan shows a heterogenous low density mass lesion with calcification(arrow).
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Figure 3
FDG-PET shows hypermetabolic masses at left nasopharynx(arrow), pelvic cavity(arrowhead) and left lower lung(black arrow). Standardized uptake values(SUVs) of nasopharynx, pelvic cavity and left lower lung are 7.1, 4.1 and 3.1, respectively.
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Figure 4
Neck CT scan shows rim-enhancing low density lesions at left nasopharyx and oropharynx (black arrow).
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Figure 5
Bronchoscopy shows an endobronchial mass covered with transparent membrane obstructing bronchus.
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Figure 6
Chronic granulomatous inflammation with caseation necrosis is seen on this section obtained from pharynx. (H&E ×400)
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