Pseudotumoral pulmonary tuberculosis: surgical experience of a rare entity

<bold>Introduction:</bold> The pseudotumoral pulmonary tuberculosis (PTPT) is extremely rare, even in endemic countries. It is a misleading radio-clinical entity, especially as it simulates bronchopulmonary cancer. In the presence of suspicious lesions with no bacteriological evidence, lung excision surgery with anatomopathological examination of the surgical specimen is essential to confirm the diagnosis. <bold>Methods:</bold> Four cases of TPPT were operated in our thoracic surgery department of ariana between 2018 and 2022. <bold>Results:</bold> Three men and one women with a mean age of 52.7 years. All of our patients were smokers. The clinico-radiological presentation was suggestive of bronchopulmonary cancer. Chest radiography revealed a heterogeneous right hilar opacity (3 cases) and an excavated formation of the right upper lobe (1 case). CT scans showed suspicious tissue formation of the right lung in all patients, associated with necrotic right laterotracheal adenopathies (1 case). Bronchial fibroscopy was normal with inconclusive biopsy. Bacteriological tests were negative. Right upper lobectomy (1 case) and atypical lung resection (3 cases) were performed. Pathological examination confirmed pulmonary tuberculosis. <bold>Conclusion:</bold> Surgery is a valuable diagnostic option for TPPT without bacteriological diagnosis, allowing early and specific medical management of the disease.