Page 90 - Livre électronique des Rencontres Franco-Tunisiennes de Pneumologie 2019

P53. PSEUDO-TUMORAL PULMONARY TUBERCULOSIS IN IMMUNOCOMPETENT ADULT

MOUNA GUERMAZI, NESRINE REGAÏEG, SOUAD YAHYAOUI, SALEM BOUOMRANI

SERVICE DE MEDECINE INTERNE, HOPITAL MILITAIRE DE GABES 6000-TUNISIE

Introduction: The pseudo-tumoral form of tuberculosis is exceptional, it accounts for only 1 to 5%
of the pulmonary tuberculosis. Because it simulates lung carcinoma, diagnosis can be delayed and
lead to abusive surgical resection.
Observation: 23-year-old Tunisian immunocompetent adult without pathological history was
explored for trailing fever, cough and thoracic pains not improved by the symptomatic treatment.
The somatic examination found a feverish patient with 38.5 °C. Biology revealed a marked
inflammatory syndrome. Chest X-ray showed a round parenchymal masse of the right upper lobe.
The patient was treated like a bacterial pneumonitis but without improvement. Lung CT scan
objectified a well limited parenchymal masse occupying the entire right upper lobe with annular
catch of contrast. Tumor makers were normal.
Bronchoscopic examination was normal without neoplasic cells on the aspiration. Direct exam for
mycobacterium tuberculosis was negative. Transbronchial lung biopsy showed granulomas with
caseation and Langhans giant cells. Under anti-tubercular therapy the evolution was favorable
with disappearance of the functional complaints and sub-total radiological cleaning at the end of
a few weeks.

Conclusion: This particular form of pulmonary tuberculosis deserves to be known especially in a
country as ours where tuberculosis remains still frequent.

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