A Case of Tuberculosis Show Off as Lung Cancer

Tuberculosis continues to be a major cause of morbidity and mortality worldwide. Patients with tuberculosis are often misdiagnosed as lung mass leading to delay in the correct diagnosis as well as exposure to unnecessary investigations and starting the treatment. we report a case of lung mass show off as tuberculosis. Introduction:50 yrs old lady presented with complaints of breathing difficulty on exertion along with cough and cold for the past 2 months. She noticed neck swelling for 2 weeks of duration. She also gives a history of low-grade fever and loss of appetite and loss of weight. On examination, she was not in respiratory distress with a respiratory rate of 18 breath-per-minute. On lung examination, breath sounds were reduced on the right upper hemithorax with a decreased dull note on percussion.The initial laboratory investigation was noncontributory except for mild anemia. The chest radiograph was done revealed homogenous opacity occupying the right upper zone.She was submitted for contrast chest computer tomography (CT) (Figure she underwent CT guided biopsy of the lung mass showed well formed granuloma with epitheloid cells and multinucleated giant cells along with, caseation necrosis consistent with tuberculosis. she was started on antituberculosis medications. She improved with medications on follow up. Discussion: TB and lung cancer have been confused and misdiagnosed for centuries .In TB endemic areas where lung cancer can be confused with TB on clinical and radiological grounds, clinicians shouldhave a high index of suspicion on TB. Radiological features suggestive of lung cancer, like mass like consolidation with irregular margins and satellite nodules, cavities, are also typical for lung tuberculosis. Differentiation according to the radiological findings can not be provided.The diagnosis has to be confirmed by pathological and microbiological tests.Differentiation lung TB from neoplasm, according to the clinical and radiological findings can be challenging.