title: Primary tuberculosis of bone mimicking a lytic bone tumor.
abstract: Causes of lytic bone lesions in children include benign, malignant, and infectious processes. Here, we present the case of a 3-year-old boy presenting with a lytic bone lesion and surrounding soft tissue mass sent for evaluation of possible malignancy versus osteomyelitis. Biopsy revealed granulomatous osteomyelitis, and subsequent purified protein derivative resulted in 20-mm induration. Lesion cultures eventually identified pan-sensitive Mycobacterium tuberculosis. We emphasize that tuberculosis can cause primary lytic bone lesions in children in the United States, even in the absence of pulmonary symptoms or known exposure, and advise clinicians to include mycobacterial cultures when analyzing biopsies of lytic bone lesions.
authors.affiliation: University of Texas Health Science Center at Houston Medical School, Department of Pathology, The Children's Cancer Hospital at MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Lemme
authors.forename: Austin
authors.initials: A
authors.lastname: Kevin Raymond
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cannon
authors.forename: Anne N
authors.initials: AN
authors.lastname: Normand
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Smith
authors.forename: Dennis P M
authors.initials: DP
authors.lastname: Hughes
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle / Q000379:methods; D001859:Bone Neoplasms / Q000175:diagnosis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012516:Osteosarcoma / Q000175:diagnosis*; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents