Pediatric pulmonary tuberculosis masquerading as chest neoplasms

Tuberculosis, a highly contagious airborne infection caused by Mycobacterium tuberculosis, can affect any organ system, although the lungs are most commonly involved. It continues to be a major cause of morbidity and mortality among children and adolescents, particularly in low- and middle-income countries. Diagnosing tuberculosis in Sub-Saharan Africa remains challenging because of its diverse clinical manifestations, atypical presentations, varying disease forms, and limited access to diagnostic resources. This case series highlights the occurrence of large pulmonary mass-like opacities due to M tuberculosis in children that can closely mimic neoplastic lesions. The pseudotumoral presentation of pulmonary tuberculosis is a rare but clinically significant form that resembles lung neoplasms and poses a considerable diagnostic challenge, particularly in pediatric patients. We report 7 cases of pseudotumoral pulmonary tuberculosis in children presenting with varying clinical manifestations. In each case, a pulmonary mass-like opacity was identified on chest radiography or computed tomography imaging and was subsequently confirmed as pulmonary tuberculosis. Diagnosing tuberculosis in children remains particularly difficult, especially in resource-limited settings. In endemic regions, maintaining a high level of clinical suspicion and correlating clinical findings with radiologic, laboratory, and histopathologic investigations are essential for timely and accurate diagnosis. Early recognition and prompt treatment of tuberculosis are crucial not only for reducing morbidity and mortality but also for preventing disease transmission.