Pulmonary tuberculoma: does persistent imaging lesion equals treatment failure?

Authors

  • Vilma Lopes Department of Pediatrics, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Porto, Portugal
  • Joana Pinho Department of Pediatrics, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Porto, Portugal
  • Maria Adriana Rangel Department of Pediatrics, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Porto, Portugal
  • Tânia Guimarães Centro de Diagnóstico Pneumológico de Penafiel, Penafiel, Porto, Portugal
  • Isabel Carvalho Department of Pediatrics, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Porto, Portugal; Centro de Diagnóstico Pneumológico de Vila Nova de Gaia, Vila Nova de Gaia, Porto, Portugal

DOI:

https://doi.org/10.18203/2349-3291.ijcp20233609

Keywords:

Pulmonary tuberculosis, Tuberculoma, Paediatrics

Abstract

Pulmonary tuberculoma is a rare but challenging entity for paediatricians, regarding diagnosis and management. Treatment course is still up for discussion since tuberculomas may persist after treatment. The authors report two paediatric cases, both recently treated for latent tuberculosis infection, admitted for investigation of a solid pulmonary nodule. In both cases the thoracic CT scan showed a nodular subpleural lesion and the biopsy revealed epithelioid cells with areas of necrosis and calcification. The diagnosis of pulmonary tuberculosis was confirmed in one case by detection of acid-fast bacilli in the smear and in the other by nucleic acid amplification test for M. tuberculosis. The patients presented good response to treatment with antituberculosis drugs, without need for surgical resection. These reports highlight the diagnostic and treatment challenges of this rare entity.

References

Mascarenhas MI, Pacheco S, Silvestre C, Felix F, Brito MJ, Correia P. Giant tuberculoma in an adolescent: atypical form of tuberculosis. BMJ Case Rep. 2012; 12:15-8.

Delgado-Pecellin I, Molinos-Quintana A, Obando-Santaella I. Giant pulmonary tuberculoma: atypical form of presentation of primary tuberculosis in childhood. Arch Bronconeumol. 2011;47(1):55-6.

Lee HS, Oh JY, Lee JH, Yoo CG, Lee CT, Kim YW, et al. Response of pulmonary tuberculomas to anti-tuberculous treatment. Eur Respir J. 2004;23(3):452-5.

Ushiki A, Yamazaki Y, Ideura G, Shinbo T, Sugawara M, Hama M, et al. Pediatric pulmonary tuberculoma with a solid pulmonary nodule detected on chest computed tomography. Intern Med. 2014;53(8):913-6.

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Published

2023-11-27

Issue

Section

Case Reports