Tubercoloma

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Il tubercoloma è una manifestazione clinica della tubercolosi che avviene per conglomerato di tubercoli e radiologicamente simula un tumore[1][2][3].

Generale

Trattandosi di evoluzioni dei complessi primari, i tubercolomi possono contenere all'interno caseum o calcificazioni.

Potendo viaggiare per via ematica e linfatica possono colpire ciascun organo, come ad esempio il cervello[4][5][6] il cieco,[7] le ovaie,[8][9] le ghiandole mammarie,[10][11][12] i polmoni,[13][14][15] l'esofago,[16][17] l'intestino,[18] il fegato,[19] il pancreas,[20][21] le ossa[22] e tanti altri.

Dalle attuali conoscenze è possibile definire il tubercoloma come una manifestazione radiologicamente uguale ad un cancro anche nelle PET e TAC.

Anche l'aspetto istologico, clinico e dei marcatori tumorali come ad esempio il CA-125 sono sovrapponibili, pertanto spesso è difficile differenziare il tubercoloma dal cancro.

Per questi motivi l'ipotesi micobatterica dovrebbe essere sempre considerata nella diagnosi differenziale del cancro.

Diagnosi

Oltre ai tradizionali esami di routine è bene precisare che il campione non va fissato, ma mandato in asciutto o al massimo con qualche goccia di acqua fisiologica in laboratorio per l'esame diretto al microscopio e poi per quello colturale[23].

Note

  1. ^ National Center for Biotechnology Information
  2. ^ The Lancet
  3. ^ National Center for Biotechnology Information
  4. ^ Dennison P, Rajakaruna G, Cerebral tuberculoma, in Thorax, vol. 61, n. 10, ottobre 2006, p. 922, DOI:10.1136/thx.2005.054932, PMC 2104774, PMID 17008487.
  5. ^ Idris MN, Sokrab TE, Arbab MA, et al., Tuberculoma of the brain: a series of 16 cases treated with anti-tuberculosis drugs, in The International Journal of Tuberculosis and Lung Disease, vol. 11, n. 1, gennaio 2007, pp. 91-5, PMID 17217136.
  6. ^ Chatterjee S, Brain tuberculomas, tubercular meningitis, and post-tubercular hydrocephalus in children, in Journal of Pediatric Neurosciences, vol. 6, Suppl 1, ottobre 2011, pp. S96–S100, DOI:10.4103/1817-1745.85725, PMC 3208909, PMID 22069437.
  7. ^ Herrick FC, Tuberculoma of the Caecum: Hyperplastic Tuberculosis, in Annals of Surgery, vol. 81, n. 4, aprile 1925, pp. 801-20, DOI:10.1097/00000658-192504000-00009, PMC 1399989, PMID 17865239.
  8. ^ Oge T, Ozalp SS, Yalcin OT, et al., Peritoneal tuberculosis mimicking ovarian cancer, in European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 162, n. 1, maggio 2012, pp. 105-8, DOI:10.1016/j.ejogrb.2012.02.010, PMID 22397744.
  9. ^ Piura B, Rabinovich A, Leron E, Yanai-Inbar I, Mazor M, Peritoneal tuberculosis mimicking ovarian carcinoma with ascites and elevated serum CA-125: case report and review of literature, in European Journal of Gynaecological Oncology, vol. 23, n. 2, 2002, pp. 120-2, PMID 12013106.
  10. ^ (HE) Wishnitzer R, Eliraz A, Sternfeld M, Pfeffermann R, [Mammary tuberculosis mimicking breast cancer], in Harefuah, vol. 117, 3–4, agosto 1989, pp. 64-5, PMID 2807064.
  11. ^ Maroulis I, Spyropoulos C, Zolota V, Tzorakoleftherakis E, Mammary tuberculosis mimicking breast cancer: a case report, in Journal of Medical Case Reports, vol. 2, 2008, p. 34, DOI:10.1186/1752-1947-2-34, PMC 2249603, PMID 18241336.
  12. ^ Winzer KJ, Menenakos C, Braumann C, Mueller JM, Guski H, Breast mass due to pectoral muscle tuberculosis mimicking breast cancer in a male patient, in International Journal of Infectious Diseases, vol. 9, n. 3, maggio 2005, pp. 176-7, DOI:10.1016/j.ijid.2004.07.007, PMID 15840460.
  13. ^ (ZH) Wang A, Xie J, 肺癌患者结核菌感染状况 [Infection of mycobacterium tuberculosis in lung cancer], in Zhongguo Fei Ai Za Zhi, vol. 1, n. 2, settembre 1998, pp. 92-4, PMID 20863474.
  14. ^ Van den Brande P, Lambrechts M, Tack J, Demedts M, Endobronchial tuberculosis mimicking lung cancer in elderly patients, in Respiratory Medicine, vol. 85, n. 2, marzo 1991, pp. 107-9, DOI:10.1016/s0954-6111(06)80286-6, PMID 1887126.
  15. ^ Matthews JI, Matarese SL, Carpenter JL, Endobronchial tuberculosis simulating lung cancer [collegamento interrotto], in Chest, vol. 86, n. 4, ottobre 1984, pp. 642-4, DOI:10.1378/chest.86.4.642, PMID 6478910.
  16. ^ Patnayak R, Reddy MK, Parthasarathy S, Yootla M, Reddy V, Jena A, Unusual presentation of esophageal tuberculosis mimicking malignancy, in Saudi Journal of Gastroenterology, vol. 14, n. 2, aprile 2008, pp. 103-4, DOI:10.4103/1319-3767.39632, PMC 2702907, PMID 19568514.
  17. ^ Ni B, Lu X, Gong Q, et al., Surgical outcome of esophageal tuberculosis secondary to mediastinal lymphadenitis in adults: experience from single center in China, in Journal of Thoracic Disease, vol. 5, n. 4, agosto 2013, pp. 498-505, PMC 3755661, PMID 23991308.
  18. ^ Chakravartty S, Chattopadhyay G, Ray D, Choudhury CR, Mandal S, Concomitant tuberculosis and carcinoma colon: coincidence or causal nexus?, in Saudi Journal of Gastroenterology, vol. 16, n. 4, 2010, pp. 292-4, DOI:10.4103/1319-3767.70619, PMC 2995101, PMID 20871197.
  19. ^ Hafezi Ahmadi M, Teimouri H, Alizadeh S, The liver Metastatic Adenocarcinoma of Colorectal Cancer With Synchronous Isolated Hepatic Tuberculosis, in Hepatitis Monthly, vol. 13, n. 5, maggio 2013, pp. e9844, DOI:10.5812/hepatmon.9844, PMC 3741692, PMID 23967026.
  20. ^ Pramesh CS, Heroor AA, Gupta SG, et al., Pancreatic tuberculosis: an elusive diagnosis, in HPB, vol. 5, n. 1, 2003, pp. 43-5, PMC 2020562, PMID 18332958.
  21. ^ Raghavan P, Rajan D, Isolated pancreatic tuberculosis mimicking malignancy in an immunocompetent host, in Case Reports in Medicine, vol. 2012, 2012, p. 501246, DOI:10.1155/2012/501246, PMC 3382406, PMID 22761624.
  22. ^ Lemme SD, Kevin Raymond A, Cannon CP, Normand AN, Smith KC, Hughes DP, Primary tuberculosis of bone mimicking a lytic bone tumor, in Journal of Pediatric Hematology/oncology, vol. 29, n. 3, marzo 2007, pp. 198-202, DOI:10.1097/MPH.0b013e31803b959f, PMID 17356403.
  23. ^ Ministero italiano della Salute (PDF), su salute.gov.it. URL consultato il 10 dicembre 2013 (archiviato dall'url originale il 14 dicembre 2013).

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