Differential diagnosis of lung nodules: breast cancer metastases and lung tuberculosis.
In a follow-up a 74-year-old woman with breast cancer (clinical stage T4N1M0 at onset, treatment by surgical resection and tamoxifen) presented a combination of two distinct diseases in the lung: breast cancer metastasis and tuberculosis. A CT scan showed multiple pulmonary nodular lesions and in only one lesion fine needle aspiration cytology (FNAC) diagnosed tuberculosis. After specific antibiotic therapy, isoniazide and rifampin, a CT scan highlighted disappearance of tubercular lesion. Because occurrence of tuberculosis during chemo or hormone therapy for metastatic breast cancer is rare, the present case is noteworthy. Indeed, it is worth pointing out the differential diagnosis of pulmonary nodular lesions in patients with cancer and the possible reactivation of tuberculosis even in patients without specific symptoms, without typical tubercular radiological features.
Endri
Mauro
M
Department of Medicine, Operative Unit of Medicine 2, Azienda Ospedaliera Santa Maria degli Angeli, Pordenone City Hospital, Pordenone, Italy.
Cartei
Giuseppe
G
Zustovich
Fable
F
Serino
Francesco Saverio
FS
Fassina
Ambrogio
A
D000368:Aged; D000730:Androstadienes / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D004967:Estrogens; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008207:Lymphatic Metastasis; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D011374:Progesterone; D012008:Recurrence; D013629:Tamoxifen / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis*
D000730:Androstadienes; D018931:Antineoplastic Agents, Hormonal; D004967:Estrogens; D013629:Tamoxifen; D011374:Progesterone; C056516:exemestane