International Journal of Clinical Case Reports 2013, Vol.3, No.4, 26
-
28
http://ijccr.sophiapublisher.com
26
Research Report Open Access
Pulmonary Tuberculosis Presenting as a V anishing Tumor of Lung: An Unknown
Presentation
Amit Kumar Verma
Shuchi Bhatt
University College of Medical Sciences Dilshad Garden, Delhi
Corresponding author email:
drshuchi@hotmail.com
International Journal of Clinical Case Reports 2013, Vol.3, No.4 doi: 10.5376/ijccr.2013.03.0004
Received: 10 Apr., 2013
Accepted: 25 Apr, 2013
Published: 02 May, 2013
Copyright: © 2013 Verma A.K., and Bhatt S., This is an open access article published under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article as:
Verma A.K., and Bhatt S., 2013, Pulmonary Tuberculosis Presenting as a Vanishing Tumor of Lung: An Unknown Presentation, International Journal of Clinical
Case Reports, Vol.3, No.4 26-28 (doi: 10.5376/ijccr.2013.03.0004)
Abstract
A 45 years old male presented with symptoms of fever, hiccoughs and chest pain. On evaluation found to have right sided
pleural fluid collection, tubercular in character. Within one week of starting anti tubercular therapy the pulmonary shadows
disappeared. An unusual with tu bercular pleural effusion. On careful evaluation we could not find any tract of lesion which could
explain possible tract of fluid. The hypothesis we could make that there was a necrotic lymph node between collection and esophagus,
which possibly had given tract to the pleural fluid to be vomited out. The tract closed spontaneously after it.
Keywords
Tuberculosis, Pleural effusion, ADA, Anti tubercular therapy, Esophageal-pleural fistula
Results
A 45 y ears old male presented in chest OPD with
history of fever for 8 weeks duration accompanied with
hiccoughs and chest pain for 6 w eeks. Fever was of
mild to moderate grade and sometime associated with
chills. There was no history of breathlessness or cough.
Two weeks later patient developed right sided chest
pain along with hiccoughs.
These symptoms were persistent and did not respond to
antibiotics and symptomatic treatment. There was n o
past history suggestive of T uberculosis, other
respiratory infection and any chronic medical illness.
On chest examination there was diminished breath
sounds on infrascapular region Rt. side. Patient was
carrying a X-RAY (Figure 1) & CECT chest (Figure 2)
which showed a l obulated well defined (bilobed)
homogenous shadow on right side posterior aspect, but
not obscuring the ri ght heart border or t he right upper
mediastinal structures. The right hilum was clearly seen
through the shadow. The upper limit was seen reaching
up to the medial right hemi-diaphragm. Left hi lum
appeared prominent and bilateral Costo-phrenic angles
were clear, malignancy, tuberculosis. After clinical
assessment patient was advised admission for fur ther
workup. On investigation the reports were Hb-13 gm./dl,
TLC
-
5 600/
mL, DLC
-
P
56
,
L
40
,
M
2
E
2
,
Blood Urea-
38
mg/dl, Sr. Createnine
-
0.8
mg/dl, ESR
-
12
mm, Sr
Na
-
140
mg/dl, Sr K
-
4.1
mg/dl.
Figure 1 Patient was carrying a X-RAY
Note: Date on film is the capturing date
Figure 2 Patient was carrying CECT chest
Note: Date on film is the capturing date