A Case Of Tuberculosis In The Cavitary Lesion Suggestive Of Neoplasm

The pathological results were nonspecific. Because the sputum culture from the patient was positive for M. tuberculosis, this lesion was evaluated as a cavitary lesion due to tuberculosis

CT plays a crucial role in differentiating between benign and malignant cavitary pulmonary lesions

Altınkaya C and Karaman A – Tuberculosis In The Cavitary Lesion

Cemile Altınkaya[1] and Adem Karaman[2]

[1] Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey.

[2] Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey.

Corresponding author: Dr. Cemile Altınkaya. E-mail: [email protected]

Financial Support: None

Conflict of Interest: The authors declare no conflicts of interest.

Editor: Manoel Otavio da Costa Rocha

Orcid

Cemile Altınkaya – https://orcid.org/0009-0003-9608-122X

Adem Karaman – https://orcid.org/0000-0002-3091-0609

A 60-year-old man was admitted to the chest disease outpatient clinic with shortness of breath, hemoptysis, and cough. Chest radiography revealed a radiopaque, round, and cavitary lesion in the lower lobe of the right lung (Figure 1). The patient underwent non-contrast thorax imaging and positron emission tomography/computed tomography (PET-CT) imaging. PET-CT showed a 61×52 mm hypermetabolic cavitary mass lesion in the lower lobe of the right lung, with a wall thickness of 13 mm at the thickest part and internal surface irregularities (Figure 2 and 3). A thoracic Tru-Cut biopsy was performed because malignancy was suspected.

The pathological results were nonspecific. Because the sputum culture from the patient was positive for M. tuberculosis, this lesion was evaluated as a cavitary lesion due to tuberculosis.

CT plays a crucial role in differentiating between benign and malignant cavitary pulmonary lesions. Radiological features suggestive of malignancy include cavity wall thickness >5 mm, irregular or nodular inner margins, presence of air-fluid levels, and increased metabolic activity on PET-CT1,2,3.

In cavitary mass lesions with malignant criteria, tuberculosis-related cavitary lesions may also exhibit hypermetabolic uptake on PET-CT4.

Acknowledgments

We would like to express our sincere gratitude to Atatürk University Research Hospital for providing technical support for the development and implementation of this study.

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