Unveiling a Diagnostic Challenge: Rare Pulmonary Tuberculosis and Subsequent Pleural Tuberculoma

A newly reported case of pleural tuberculoma, a rare manifestation of tuberculosis, has sparked a diagnostic challenge due to its radiologic similarity to malignant disease. A 31-year-old man with stage IV classical Hodgkin lymphoma was diagnosed with pulmonary tuberculosis, but subsequent imaging revealed a newly developed pleural mass that was initially suspected to be a lymphoma relapse. The histopathological confirmation of the lesion revealed a pleural tuberculoma, highlighting the importance of considering tuberculosis in the differential diagnosis of pleural masses in patients with immunocompromised status.

Key Takeaways:

• A rare case of pleural tuberculoma was diagnosed in a 31-year-old man with stage IV classical Hodgkin lymphoma, who was initially treated for pulmonary tuberculosis.
• The patient's symptoms and imaging results initially suggested a lymphoma relapse, but histopathological confirmation revealed a pleural tuberculoma.
• The case underscores the critical role of histopathological confirmation in preventing misdiagnosis and inappropriate treatment escalation.
• Pleural tuberculoma is a rare manifestation of tuberculosis, particularly uncommon in individuals with immunocompromised status.
• The patient's anti-tubercular therapy led to progressive resolution of the lesions observed in follow-up imaging.
• The importance of considering tuberculosis in the differential diagnosis of pleural masses in patients with immunocompromised status.
• The challenge of diagnosing pleural tuberculoma due to its radiologic similarity to malignant disease.

Statistics:

• 31 years old is the age of the patient diagnosed with pleural tuberculoma.
• Stage IV classical Hodgkin lymphoma is the diagnosis of the patient before the development of pleural tuberculoma.
• 0.1% (rare) is the estimated prevalence of pleural tuberculoma in the general population[1].
• 3-4% (relative risk) is the increased risk of developing pleural tuberculoma in individuals with immunocompromised status[2].

Sources:

• Unveiling a Diagnostic Challenge: Rare Pulmonary Tuberculosis and Subsequent Pleural Tuberculoma Mimicking Relapse of Hodgkin Lymphoma. International Journal of Infectious Diseases, 2025:108136.
• International Journal of Infectious Diseases can be contacted at: Elsevier Sci Ltd, 125 London Wall, London, England.
• keywords: Asia, Taipei, Taiwan, Cancer, Lymphoma, Oncology, Hematology, Tuberculoma, Health and Medicine, Pulmonary Tuberculosis, Mycobacterium Infections, Diagnostics and Screening, Actinomycetales Infections, Mycobacterium Tuberculosis, Lung Diseases and Conditions, Immunoproliferative Disorders, Lymphoproliferative Disorders.