Misdiagnosis of Lung Adenocarcinoma Mimicking of Pulmonary Tuberculosis: A Case Report

Abstract

Background: Pulmonary abnormalities caused by lung cancer can be clinically and radiologically similar to pulmonary tuberculosis (TB). Pulmonary symptom of TB and lung cancer overlap each other such as chronical dyspnea, coughing, hemoptysis, chronic pain and weight loss. Radiologically such as cavities, infiltrates, nodules and miliary. These similarities make it challenging for clinicians and 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 chronic cough for three months, accompanied by symptoms of atypical chest pain, weight loss and indigestion. Chest physical examination found dullness of percussion and decrease breath sound on left side hemithorax. Chest X-ray showed cavity in the left lung. The bronchoscopy result showed mass in the left bronchial and left upper lobe. Biopsy results were obtained adenocarcinoma.

Discussion: Pulmonary tuberculosis and lung cancer often mimic each other on imaging, sharing features such as irregular consolidations and thick-walled cavities. This similarity frequently leads to diagnostic confusion and potential misclassification, especially in regions with high tuberculosis prevalence. Accurate distinction requires thorough pathological and microbiological confirmation to ensure proper management.

Conclusions: 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.