Respir Case Rep. 2017; 6(1): 45-47 | DOI: 10.5505/respircase.2017.75436

HIV Seronegatif Hastada Parasternal Tüberküloz ve Ýnsidental Abdominal Kitle

Deniz Kýzýlýrmak¹, Müjgan Zuhal Güler², Ebru Ünsal³, Filiz Çimen², Nermin Çapan^2
1Turgut Özal Üniversitesi Týp Fakültesi, Göðüs Hastalýklarý Ana Bilim Dalý, Ankara
²Atatürk Göðüs Hastalýklarý Ve Göðüs Cerrahisi Eðitim Ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Ana Bilim Dalý, Ankara
³Yýldýrým Beyazýt Üniversitesi Týp Fakültesi, Göðüs Hastalýklarý Ana Bilim Dalý, Ankara

Yumuþak doku tüberkülozu nadir görülen akciðer dýþý tüberküloz formudur. Özellikle primer akciðer tüberkülozunun eþlik etmediði durumlarda klinik olarak malignite ile karýþabilmektedir. Olgumuz, HIV seronegatif, 39 yaþýnda bir bayan hastadýr. Sternum ön kýsmýnda ele gelen þiþlik þikâyeti olan hastaya kitle rezeksiyonu yapýlmýþ ve patolojisi kazeifiye granülomatöz inflamasyon olarak raporlanmýþtýr. Hastaya ‘yeni olgu akciðer dýþý tüberküloz’ tanýsýyla dörtlü anti-TB tedavi baþlandý. Fizik muayenesinde sað alt kadran hassasiyeti saptanan hastanýn abdomen ultrasonunda ve tomografisinde sað alt kadranda kitle lezyonu görüldü. Gastroenteroloji tarafýndan kolonoskopide; çýkan kolonda, biyopsi sonrasýnda pürülan bir akýntýnýn boþaldýðý kitle görüldü. Hastanýn patoloji raporu granülomatöz nekroz olarak yorumlandý. Yumuþak doku tüberkülozu tanýsý ile takip edilen hastaya, eþlik eden gastrointestinal tüberküloz tanýsý konuldu ve hastanýn tedavi süresi 9 ay olarak uzatýldý. Tüberküloz nedeni ile takip edilen hastalarda, sistem sorgularý ve fizik muayeneleri, baþka bir tüberküloz odaðýnýn belirtisini de ortaya çýkarabilmektedir. Olgumuzda eþlik eden gastrointestinal tüberküloz tanýsý nedeni ile tedavi süresi uzamýþtýr.

Anahtar Kelimeler: Akciðer dýþý tüberküloz, abdominal, kitle

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Parasternal Tuberculosis and Incidental Abdominal Mass in an HIV Seronegative Patient

Deniz Kýzýlýrmak¹, Müjgan Zuhal Güler², Ebru Ünsal³, Filiz Çimen², Nermin Çapan^2
1Department of Pulmonary Diseases, Turgut Özal University Faculty of Medicine, Ankara, Turkey
²Department of Pulmonary Diseases, Atatürk Chest Diseases and Chest Surgery Education and Training Hospital, Ankara, Turkey
³Department of Pulmonary Diseases, Yýldýrým Beyazýt University Faculty of Medicine, Ankara, Turkey

Soft tissue tuberculosis is a rare form of extrapulmonary tuberculosis. It can be clinically confused with malignancy, particularly in cases without accompaniment of primary pulmonary tuberculosis. A 39-year-old female, HIV-seronegative patient was admitted with a complaint of a palpable swelling in front of the sternum. After surgical resection, the pathological result was reported as granulomatous inflammation. The patient was diagnosed with extrapulmonary tuberculosis, and anti-tuberculosis treatment was started. She had tenderness in the right lower quadrant on physical examination. Ultrasound and tomography scans showed a 6x5 cm mass in the right lower quadrant. Colonoscopy revealed a mass on the ascending colon, in which purulent discharge after biopsy was reported. Its pathology result was reported as granulomatous necrosis. We diagnosed the patient with soft tissue tuberculosis with concomitant gastrointestinal tuberculosis. She received treatment for nine months.

Keywords: Extrapulmonary tuberculosis, abdominal, mass

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