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Tuberculosis masquerading as malignancy: a multimodality approach to the correct diagnosis - a case report.

Amukotuwa S, Choong PF, Smith PJ, Powell GJ, Slavin J, Schlicht SM - Int Semin Surg Oncol (2005)

Bottom Line: As a result, patients may be referred to oncologists and surgeons for further evaluation and management, delaying the institution of appropriate anti-tuberculous drug therapy.Further investigation revealed extensive retroperitoneal abdominal and pelvic lymphadenopathy.The recognition of certain patterns on imaging, and finally the isolation of Mycobacterium tuberculosis from tissue samples obtained under image guidance, enabled the correct diagnosis to be made.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Imaging, St, Vincent's Hospital, Fitzroy 3065, Melbourne, Australia. shalini.AMUKOTUWA@svhm.org.au.

ABSTRACT
BACKGROUND: Extrapulmonary tuberculosis is one of the great mimickers of medicine, and often masquerades as malignancy. As a result, patients may be referred to oncologists and surgeons for further evaluation and management, delaying the institution of appropriate anti-tuberculous drug therapy. CASE PRESENTATION: We present the case of a 21 year old man with tuberculous osteomyelitis, who was referred to the Bone and Soft Tissue Sarcoma Service at our institution with a provisional diagnosis of malignancy. Further investigation revealed extensive retroperitoneal abdominal and pelvic lymphadenopathy. The recognition of certain patterns on imaging, and finally the isolation of Mycobacterium tuberculosis from tissue samples obtained under image guidance, enabled the correct diagnosis to be made. CONCLUSION: This case highlights the importance of remaining cognisant of the protean manifestations of extrapulmonary tuberculosis, and illustrates the advantage of a clinically directed multi-modality imaging approach to diagnosis.

No MeSH data available.


Related in: MedlinePlus

CT guided core biopsy of the elbow. A. Tissue adjacent to proximal ulna, at the level of the elbow joint, was obtained under CT guidance. B. Histological examination, after haematoxylin and eosin staining, demonstrated non-specific chronic inflammation and numerous polymorphonuclear cells.
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Figure 8: CT guided core biopsy of the elbow. A. Tissue adjacent to proximal ulna, at the level of the elbow joint, was obtained under CT guidance. B. Histological examination, after haematoxylin and eosin staining, demonstrated non-specific chronic inflammation and numerous polymorphonuclear cells.

Mentions: Biopsy of the right elbow joint demonstrated chronic synovial inflammation and numerous polymorphonuclear cells in the synovial fluid, but no malignant cells (Figure 8). Microbiological examination, including staining for acid-fast bacilli and fungi, revealed no organisms.


Tuberculosis masquerading as malignancy: a multimodality approach to the correct diagnosis - a case report.

Amukotuwa S, Choong PF, Smith PJ, Powell GJ, Slavin J, Schlicht SM - Int Semin Surg Oncol (2005)

CT guided core biopsy of the elbow. A. Tissue adjacent to proximal ulna, at the level of the elbow joint, was obtained under CT guidance. B. Histological examination, after haematoxylin and eosin staining, demonstrated non-specific chronic inflammation and numerous polymorphonuclear cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1131917&req=5

Figure 8: CT guided core biopsy of the elbow. A. Tissue adjacent to proximal ulna, at the level of the elbow joint, was obtained under CT guidance. B. Histological examination, after haematoxylin and eosin staining, demonstrated non-specific chronic inflammation and numerous polymorphonuclear cells.
Mentions: Biopsy of the right elbow joint demonstrated chronic synovial inflammation and numerous polymorphonuclear cells in the synovial fluid, but no malignant cells (Figure 8). Microbiological examination, including staining for acid-fast bacilli and fungi, revealed no organisms.

Bottom Line: As a result, patients may be referred to oncologists and surgeons for further evaluation and management, delaying the institution of appropriate anti-tuberculous drug therapy.Further investigation revealed extensive retroperitoneal abdominal and pelvic lymphadenopathy.The recognition of certain patterns on imaging, and finally the isolation of Mycobacterium tuberculosis from tissue samples obtained under image guidance, enabled the correct diagnosis to be made.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Imaging, St, Vincent's Hospital, Fitzroy 3065, Melbourne, Australia. shalini.AMUKOTUWA@svhm.org.au.

ABSTRACT
BACKGROUND: Extrapulmonary tuberculosis is one of the great mimickers of medicine, and often masquerades as malignancy. As a result, patients may be referred to oncologists and surgeons for further evaluation and management, delaying the institution of appropriate anti-tuberculous drug therapy. CASE PRESENTATION: We present the case of a 21 year old man with tuberculous osteomyelitis, who was referred to the Bone and Soft Tissue Sarcoma Service at our institution with a provisional diagnosis of malignancy. Further investigation revealed extensive retroperitoneal abdominal and pelvic lymphadenopathy. The recognition of certain patterns on imaging, and finally the isolation of Mycobacterium tuberculosis from tissue samples obtained under image guidance, enabled the correct diagnosis to be made. CONCLUSION: This case highlights the importance of remaining cognisant of the protean manifestations of extrapulmonary tuberculosis, and illustrates the advantage of a clinically directed multi-modality imaging approach to diagnosis.

No MeSH data available.


Related in: MedlinePlus