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Tuberculosis masquerading as malignancy: a multimodality approach to the correct diagnosis - a case report
Shalini Amukotuwa1, Peter Fm Choong, Peter J Smith
1Department of Medical Imaging, St, Vincent's Hospital, Fitzroy 3065, Melbourne, Australia. shalini.AMUKOTUWA@svhm.org.au.
International Seminars in Surgical Oncology : ISSO
|May 10, 2005
Summary
Extrapulmonary tuberculosis can mimic cancer, delaying diagnosis and treatment. Early recognition through imaging and tissue analysis is crucial for effective management of this challenging condition.
Area of Science:
- Oncology
- Infectious Diseases
- Radiology
Background:
- Extrapulmonary tuberculosis (TB) frequently mimics malignancy, leading to delayed diagnosis.
- Patients may be incorrectly referred to oncologists and surgeons.
- This delay hinders timely initiation of anti-tuberculous drug therapy.
Purpose of the Study:
- To highlight the diagnostic challenges posed by extrapulmonary TB.
- To emphasize the importance of considering TB in patients presenting with malignancy-like symptoms.
- To showcase the utility of a multi-modality imaging approach.
Main Methods:
- Case presentation of a 21-year-old male with tuberculous osteomyelitis.
- Diagnostic workup included imaging for retroperitoneal, abdominal, and pelvic lymphadenopathy.
- Mycobacterium tuberculosis was isolated from image-guided tissue samples.
Main Results:
- The patient was initially referred with a suspected bone and soft tissue sarcoma.
- Extensive lymphadenopathy was identified on imaging.
- Microbiological confirmation of tuberculosis was achieved through tissue analysis.
Conclusions:
- Extrapulmonary TB presents with diverse manifestations that can mislead clinicians.
- A high index of suspicion for TB is essential, even when malignancy is suspected.
- A clinically guided, multi-modality imaging strategy aids in accurate diagnosis.