Pseudotumour presentation of pulmonary tuberculosis

Pulmonary tuberculosis manifesting as a mass lesion, thus, mimicking a lung carcinoma is an unusual radiographic presentation of tuberculosis (TB). The common radiologic patterns and clinical presentations are well known and documented. We report two cases of pulmonary tuberculosis with a neoplastic appearance on chest imaging diagnosed histologically. A 21 – year old female with cough, weight loss, anorexia and an unremarkable physical examination. Chest radiography showed a right apical mass suggestive of lung cancer. Histology of the lesion revealed parenchymal pulmonary tuberculosis. A 49–year old male with left-sided chest pain, cough, anorexia, weight loss, mild pallor with an unremarkable chest examination. Chest imaging showed a left apical mass and mediastinal lymphadenopathy. Microscopic examination of the mass confirmed pulmonary tuberculosis. Pseudotumour pulmonary tuberculosis is a rare clinical entity that can lead to diagnostic challenges and must be considered in the differential diagnosis when mass lesions are seen on chest imaging, especially in TB endemic areas.Keywords: tuberculosis, pulmonary, carcinoma, atypical, diagnosticFunding: None declare

Post-mortem tuberculous lesions: their prevalence and distribution in 404 consecutive examinations conducted at the Royal Infirmary, Edinburgh.

1. Tuberculous lesions were found in 69 per cent. of persons (386) who died in the Royal Infirmary, Edinburgh, from disease other than tuberculosis.2. In 50 per cent. of cases calcareous, that is healed lesions were found.3. In 9 per cent. the lesions were quiescent and in another 9 per cent. they were active.4. Lungs and tracheo-bronchial glands are the organs most frequently involved in adults.5 . Lungs, tracheo-bronchial glands and mesenterie glands in that order, are the most common sites of tubercle.6. Other organs, except cervical glands, are always infected secondarily to those mentioned above.7. Tuberculosis of the kidney is always secondary and does not heal.8. There is evidence of a marked tuberculisation occurring during infancy of abdominal type and of a late and more constant tuberculisation affecting lungs and bronchial glands in later life.9. Evidence is afforded by the figures relating to abdominal glandular lesions of a marked tendency for these lesions to disappear within` the individual. The degree of tuberculisation of the population must therefore very considerably exceed the percentage of the tuberculous lesions which have been proved in this series of examinations. It must be greater than 69 per cent.10. The facts which have been obtained from the study of this particular population indicate that in order that correct conclusions may be obtainable from post-mortem material, the factors of age incidence with respect to the various manifestations of the disease must be taken into account.11. From the facts demonstrated that tuberculosis in later life is mainly pulmonary in type and subacute or chronic in nature and that in a large proportion of cases the pulmonary must have been preceded in the individual by definite abdominal tuberculosis, it would appear that a resistance to this disease is active during later life, . and that the disease in a large number of instances must.h &ve been due to alighting up of an early infection and not to an reinfection

Coinfection of Tuberculosis Pneumonia and COVID-19 in a Patient Vaccinated with Bacille Calmette-Guérin (BCG). Case Report

COVID-19 is a respiratory tract infection caused by the new coronavirus SARS-COV2 that can be complicated by acute distress respiratory syndrome and multiorgan failure. In light of the high rate of mortality associated with COVID-19, pharmacological and non-pharmacological strategies to prevent the infection are currently being tested. Among non-pharmacological preventive measures, vaccines represent one of the main resources for public health. It has been suggested that Bacille Calmette-Guérin (BCG) vaccine may protect individuals against infection from COVID-19 virus, and two clinical trials addressing this question are underway. Here, we report the case of a 32-year-old woman, vaccinated with BCG when she was 1 year old, who was diagnosed with apical tuberculous pneumonia of the right lung along with COVID 19 pneumonia

Radiographic spectrum of adult pulmonary tuberculosis in a developed country

AbstractSetting. Bispebjerg Hospital, Department of Pulmonary Medicine P. The referral centre of adult tuberculosis in the municipality of Copenhagen, Denmark.Objective. To evaluate the radiographic spectrum of pulmonary tuberculosis (TB) in adults in a low-prevalence country and to correlate radiographic appearances with bacteriological results, clinical and demographic data.Design. Retrospective review of medical files on 548 cases with pulmonary TB according to the criteria of WHO.Results. Usual radiographic pattern of reactivating TB, with upper lobe involvement, was found in 92% (n=504). eight percent (n=44) showed unusual X-ray patterns for adults, such as isolated lower lobe infiltrations (n=19), hilar adenopathy (n=10), miliary TB (n=7), tuberculoma (n=2), pleural effusion (n=1) and normal chest X-ray (n=3). Eighty-nine percent of cases with cavitary lesions were positive by microscopy.Conclusion. The risk of missing a diagnosis of pulmonary TB may be high if patients present with an X-ray unusual for TB, but this is fortunately seen only in 8% of cases of pulmonary tuberculosis. Unusual X-ray is more commonly found in patients with concomitant disease, such as diabetes and cancer.If chest X-ray shows cavities, but the smear is negative for Mycobacterium, TB is unlikely and further diagnostic procedures should be performed without waiting for culture results

Study of tuberculosis as met with in childhood and adolescence in Scotland and in Manchuria

In dealing with the subject of Tuberculosis in early life, I have selected three clinical forms of the disease, viz. Pulmonary Tuberculosis, Cervical Adenitis, and Abdominal Tuberculosis, all of which are met with in childhood and adolescence, and I propose to draw some comparisons between their occurrence as I have observed it in Scotland and in Manchuria. The point of special interest in these comparisons is that in Scotland Bovine Tuberculosis is an important factor in the causation of much of the Tuberculosis met with in children, whereas in Manchuria the possibility of Bovine infection may be entirely excluded, as cow's milk is not used as an article of food by either children or adults. In this way I hope, while corroborating existing theories, to throw new light on ideas regarding the factors contributing to the causation and spread of Tuberculosis among children and young people in Scotland. In Part I, I have dealt with the forms of the disease in question from the standpoint of their occurrence in Scotland, and have discussed the following:- (1). Mortality Rate, with Tables from the Registrar - General's Returns. (2). Heredity and its bearing on the subject of Tuberculosis, with results of investigations. (3). Importance of early diagnosis of Pulmonary Tuberculosis in children. (4). Bovine Tuberculosis and its relation to Tuberculosis in children, with results of investigations. Important relationship of clinical data and milk supply. In Part II, I have introduced the subject of Tuberculosis in Manchuria by giving a general outline of the Manners and Customs of the people as having an important bearing on the question of Incidence Mortality. Thereafter I have taken seriatim the three selected clinical forms of Tuberculosis, and have discussed each one from the point of view of Age Incidence, Predisposing Causes, Prognosis and Treatment. The final Summary embodies the salient points of the Thesis, more particularly those relating to Bovine Infection during the milk- drinking period of life, while the Conclusions are directed towards more efficient supervision and control of the milk supply, together with a recommendation for compulsory sterilisation of covets milk ere it be used for the purposes of infant feeding