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Pleural tuberculosis presented as multiple pleural masses: An atypical presentation.
Anand Patel1, Sushmita Choudhury
1Department of Pulmonary Medicine, Smt. B. K. Shah Medical Institute and Research Centre, Sumandeep Vidhyapeeth, Piparia, Vadodara, Gujarat, India.
Lung India : Official Organ of Indian Chest Society
|May 11, 2013
Summary
This study highlights a rare presentation of pleural tuberculosis in a 68-year-old male, featuring multiple masses and effusion. Diagnosis was confirmed through biopsy, emphasizing the need for considering tuberculosis in atypical pleural disease.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Pleural tuberculosis typically manifests as effusion, empyema, or thickening.
- Rare presentations include multiple pleural masses without parenchymal or lymph node involvement.
- Distinguishing these rare forms from other conditions like mesothelioma is clinically challenging.
Purpose of the Study:
- To report a rare case of unilateral pleural tuberculosis presenting as multiple nodular masses.
- To illustrate the diagnostic challenges and imaging findings in such atypical cases.
- To emphasize the importance of pathological confirmation for accurate diagnosis.
Main Methods:
- Case report of a 68-year-old male with unilateral pleural disease.
- Diagnostic workup included computed tomography (CT) of the chest and pleuroscopy.
- Biopsy of pleural masses for histopathological examination.
Main Results:
- Chest CT revealed multiple, varied-sized nodular pleural masses with a large hemorrhagic effusion.
- Pleuroscopy confirmed the presence of multiple pleural masses.
- Pathological examination showed epithelioid cell granulomas, confirming tuberculous etiology.
Conclusions:
- Pleural tuberculosis can present rarely as multiple masses mimicking other malignancies.
- Multimodality imaging (CT, pleuroscopy) is crucial for characterizing pleural lesions.
- Histopathological analysis remains the gold standard for diagnosing pleural tuberculosis.
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