Tumorous Endobronchial Tuberculosis Mimicking Lung Neoplasm: A Diagnostic Challenge in a Middle-aged Female.
K Jisna, V Jereen, A Arthi et al.
✦ AI-curated · Sources linked
Case in brief
A 45-year-old woman with obstructive airway disease and type 2 diabetes presented with progressive dyspnea, cough, low-grade evening fever, and weight loss. Imaging showed a left hilar-to-upper-lobe lesion with branching projections, and bronchoscopy found a vascular polypoidal mass narrowing the lingular bronchus, raising concern for malignancy. Cytology and histopathology showed no neoplastic cells; bronchoalveolar lavage CBNAAT detected rifampicin-sensitive Mycobacterium tuberculosis, confirming tumorous endobronchial tuberculosis. She improved with antitubercular therapy; residual lesion on follow-up prompted extension of treatment to a total of 9 months, with continued clinical and radiological improvement.
What made this case unusual
The endobronchial lesion appeared mass-like on imaging and bronchoscopy, closely resembling lung malignancy despite negative cytology and histopathology.
Diagnostic / clinical pearl
A mass-like endobronchial lesion is not necessarily neoplastic; when malignancy is suspected, bronchoscopy with molecular testing of lavage can establish tuberculosis even when cytology and histopathology are negative.
Why it matters
Recognizing this mimic may help avoid unnecessary invasive procedures and delays in appropriate treatment.