Abstract YO26
Case summary
Misdiagnosis of Lung Adenocarcinoma Mimicking Manifestations of Pulmonary Tuberculosis: A Case Report Introduction Lung cancer causes pulmonary abnormalities that can be clinically and radiologically similar to pulmonary tuberculosis (TB) such as cavities, infiltrates, nodules and miliary. Clinical and radiologically overlap made it challenging for clinicians to diagnose. The dilemma of these similarities causes misdiagnosis with incidence between 0.03% and 30,4% worldwide. Case Presentation A 65-year-old male with chief complaint of shortness of breath and cough for three months, condition worsened and symptoms aggravated in the last two months accompanied by symptoms of atypical chest pain and weight loss. Auscultation found decreased of left lung vesicular and dull sound on percussion. Chest X-ray showed cavity in the left hemithorax, confirmed by Chest CT scan showed a mass in the left lung. Biopsy results from bronchoscopy were obtained adenocarcinoma. Discussion Cavities appear in one in six bronchial carcinoma, cavities are gas-filled lesions that appear in the mass zone in the lung. Most commonly the result of the of expulsion of necrotic tissue through the bronchial tree and tumor infiltrate thus proteases and mucins are able to damage the alveolar walls. The appearance of radiologic features similar to pulmonary TB results in misdiagnosis conditions. The USA received 26 (0.03%) cases in 10 years, Rolston et.al, in a 3-year study found 37 patients (1.3%) were misdiagnosed, India 14 from 70 (20%) were misdiagnosed and Indonesia 30,4% misdiagnosed. Similar to this case with the appearance of cavity, but with the help of further examination and clinician expertise, the diagnosis was well established. Conclusion Diagnosing pulmonary tuberculosis and lung adenocarcinoma is challenging especially based on similarity of clinical and radiological findings, resulting in significant misdiagnosis. Further examinations and clinician expertise are essential to differentiate. Keywords: Lung Adenocarcinoma, Pulmonary Tuberculosis, Misdiagnosis