Cargando…

A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature

Silicosis caused by the inhalation/deposition of free silica particles is characterized by pulmonary inflammation/fibrosis. Among the clinical disorders associated with silicosis, tuberculosis is by far the most prominent. A 66-year-old male non-smoker, originally from North Africa, reported a dry c...

Descripción completa

Detalles Bibliográficos
Autores principales: D’Sa, Lauren, Pezzuto, Federica, Lunardi, Francesca, Scalvenzi, Francesca, Tinè, Mariaenrica, Comacchio, Giovanni, Giraudo, Chiara, Calabrese, Fiorella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10486577/
https://www.ncbi.nlm.nih.gov/pubmed/37685266
http://dx.doi.org/10.3390/diagnostics13172728
_version_ 1785103039468666880
author D’Sa, Lauren
Pezzuto, Federica
Lunardi, Francesca
Scalvenzi, Francesca
Tinè, Mariaenrica
Comacchio, Giovanni
Giraudo, Chiara
Calabrese, Fiorella
author_facet D’Sa, Lauren
Pezzuto, Federica
Lunardi, Francesca
Scalvenzi, Francesca
Tinè, Mariaenrica
Comacchio, Giovanni
Giraudo, Chiara
Calabrese, Fiorella
author_sort D’Sa, Lauren
collection PubMed
description Silicosis caused by the inhalation/deposition of free silica particles is characterized by pulmonary inflammation/fibrosis. Among the clinical disorders associated with silicosis, tuberculosis is by far the most prominent. A 66-year-old male non-smoker, originally from North Africa, reported a dry cough and significant weight loss. He was a foundry worker. He had a medical history of bladder carcinoma associated with schistosomiasis. Computed tomography (CT) and positron emission tomography (PET)/CT showed bilateral multiple hypermetabolic lung nodules, some with cavitation. The patient underwent surgical resection of the largest nodule, which was highly suspicious of lung metastasis. The histological examination revealed multiple nodular formations. Several lesions showed the characteristic features of silicotic nodules. There were also adjacent well-formed granulomas, some with central caseous necrosis. A real-time polymerase chain reaction, performed for the identification and quantification of the DNA of the Mycobacterium tuberculosis complex, was positive. Pulmonary silico-tuberculosis is often encountered in patients with a history of silica exposure in tuberculosis-endemic areas. This case serves as a reminder to never underestimate patient occupational exposure and geographic origin. A careful histological diagnosis and molecular investigation are mandatory when approaching difficult cases, especially patients with a prior cancer history and clinical/radiological features suggestive of tumour recurrence/metastasis.
format Online
Article
Text
id pubmed-10486577
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-104865772023-09-09 A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature D’Sa, Lauren Pezzuto, Federica Lunardi, Francesca Scalvenzi, Francesca Tinè, Mariaenrica Comacchio, Giovanni Giraudo, Chiara Calabrese, Fiorella Diagnostics (Basel) Interesting Images Silicosis caused by the inhalation/deposition of free silica particles is characterized by pulmonary inflammation/fibrosis. Among the clinical disorders associated with silicosis, tuberculosis is by far the most prominent. A 66-year-old male non-smoker, originally from North Africa, reported a dry cough and significant weight loss. He was a foundry worker. He had a medical history of bladder carcinoma associated with schistosomiasis. Computed tomography (CT) and positron emission tomography (PET)/CT showed bilateral multiple hypermetabolic lung nodules, some with cavitation. The patient underwent surgical resection of the largest nodule, which was highly suspicious of lung metastasis. The histological examination revealed multiple nodular formations. Several lesions showed the characteristic features of silicotic nodules. There were also adjacent well-formed granulomas, some with central caseous necrosis. A real-time polymerase chain reaction, performed for the identification and quantification of the DNA of the Mycobacterium tuberculosis complex, was positive. Pulmonary silico-tuberculosis is often encountered in patients with a history of silica exposure in tuberculosis-endemic areas. This case serves as a reminder to never underestimate patient occupational exposure and geographic origin. A careful histological diagnosis and molecular investigation are mandatory when approaching difficult cases, especially patients with a prior cancer history and clinical/radiological features suggestive of tumour recurrence/metastasis. MDPI 2023-08-22 /pmc/articles/PMC10486577/ /pubmed/37685266 http://dx.doi.org/10.3390/diagnostics13172728 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Interesting Images
D’Sa, Lauren
Pezzuto, Federica
Lunardi, Francesca
Scalvenzi, Francesca
Tinè, Mariaenrica
Comacchio, Giovanni
Giraudo, Chiara
Calabrese, Fiorella
A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature
title A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature
title_full A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature
title_fullStr A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature
title_full_unstemmed A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature
title_short A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature
title_sort complex case of pulmonary silico-tuberculosis and review of literature
topic Interesting Images
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10486577/
https://www.ncbi.nlm.nih.gov/pubmed/37685266
http://dx.doi.org/10.3390/diagnostics13172728
work_keys_str_mv AT dsalauren acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT pezzutofederica acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT lunardifrancesca acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT scalvenzifrancesca acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT tinemariaenrica acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT comacchiogiovanni acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT giraudochiara acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT calabresefiorella acomplexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT dsalauren complexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT pezzutofederica complexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT lunardifrancesca complexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT scalvenzifrancesca complexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT tinemariaenrica complexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT comacchiogiovanni complexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT giraudochiara complexcaseofpulmonarysilicotuberculosisandreviewofliterature
AT calabresefiorella complexcaseofpulmonarysilicotuberculosisandreviewofliterature