Uncommon Presentation of Tuberculosis as an Incidentally Discovered Solitary Pleural Tuberculoma

A 54-year-old Japanese man with unremarkable social and medical history presented with an abnormal shadow on his chest X-ray during an annual company health checkup. He had the bacille Calmette-Guérin vaccination as a child and had no smoking/foreign travel history. He was asymptomatic, with normal...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2021-10, Vol.106 (2), p.376-377
Main Authors: Kinjo, Takeshi, Shimoji, Mitsuyoshi, Fujita, Jiro
Format: Article
Language:English
Subjects:
Humans
Images in Clinical Tropical Medicine
Incidental Findings
Lung Neoplasms - surgery
Male
Middle Aged
Thoracoscopy
Tomography, X-Ray Computed
Tuberculoma - diagnosis
Tuberculoma - diagnostic imaging
Tuberculoma - therapy
Tuberculosis
Tuberculosis, Pleural - diagnosis
Tuberculosis, Pleural - diagnostic imaging
Tuberculosis, Pleural - therapy
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Summary:A 54-year-old Japanese man with unremarkable social and medical history presented with an abnormal shadow on his chest X-ray during an annual company health checkup. He had the bacille Calmette-Guérin vaccination as a child and had no smoking/foreign travel history. He was asymptomatic, with normal vital signs. He had a white blood cell count of 6,610 cells/µL and a C-reactive protein level of 0.11 mg/dL. Chest X-ray revealed a mass with an incomplete border sign in the right lower lung field. Contrast-enhanced chest computed tomography revealed an encapsulated and peripherally enhancing low-attenuation mass adjacent to the posterolateral chest wall that exhibited an extra-pleural sign. No pleural effusion was observed. Because a chest wall tumor was suspected, video-assisted thoracoscopic surgery for tumor resection was performed. During the surgery, the mass discharged white viscous pus; a specimen was collected, which later tested positive for Mycobacterium tuberculosis complex using a real-time polymerase chain reaction assay targeting 16S recombinant RNA.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.21-0740