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Pulmonary and Intraabdominal Tuberculosis Mimicking Lung Malignancy with Intraabdominal Metastasis on CT: A Case Report
摘要
A 60-year-old male patient suffered from fever off and on for 1 month. The laboratory examination revealed leukocytosis and elevated C-reactive protein. The sputum showed positive acid-fast stain. The chest radiograph demonstrated a cavitated consolidation in right upper lung. Computed tomography (CT) showed a cavitated consolidation in right upper lobe of lung involving the mediastinum and encasing the superior vena cava and the ascending branch of right pulmonary artery. Enlarged mediastinal lymph nodes, bilateral adrenal gland enlargement, peritoneal thickening, omental cake appearance, ascites and bilateral pleural effusion were also found. Therefore, CT diagnosis of lung carcinoma with invasion to the mediastinum, metastasis to bilateral adrenal glands, and peritoneal carcinomatosis was made. Ultrasound (US)-guided paracentesis was carried out; the cytological findings showed predominant multinuclear cells. Percutaneous biopsy under US-guidance was performed for the right lung mass; the pathological result demonstrated caseating granulomas. Acid-fast bacilli were found after special staining for tuberculosis (TB) bacilli. The final diagnosis was pulmonary and intraabdominal TB.
延伸閱讀
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