Open AccessA case of pulmonary tuberculosis with multiple nodules mimicking lung metastases
Author(s) -
Kazuhiko Morikawa,
Shigeki Misumi,
Taiki Fukuda
Publication year - 2019
Publication title -
bjr case reports
Language(s) - English
Resource type - Journals
ISSN - 2055-7159
DOI - 10.1259/bjrcr.20180124
Subject(s) - medicine , differential diagnosis , asymptomatic , nodule (geology) , lung , pulmonary tuberculosis , tuberculosis , solitary pulmonary nodule , radiology , radiography , pathology , paleontology , biology
Tuberculosis (TB) may present as multiple pulmonary nodules mimicking lung metastases. Many asymptomatic cases of TB are detected incidentally on chest radiography, and patients are often negative for acid-fast bacilli staining and culture in spite of having active TB. It is important to know the imaging findings characteristic of pulmonary TB and its variant forms. Multiple pulmonary nodules were detected in an 80-year-old female during a medical checkup. TB was not suspected until her imaging findings worsened; however, in retrospect, centrilobular micronodules were observed amongst multiple well-circumscribed nodules on the initial images and worsened during conservative management. Although bilateral multiple well-circumscribed pulmonary nodules are suggestive of metastases, when a nodule surrounded by centrilobular or satellite micronodules is found, even in the absence of characteristic findings such as cavitation or the tree-in-bud sign, pulmonary TB should be considered in the differential diagnosis to prevent delays in treatment.