Immunocyte count combined with CT features for distinguishing pulmonary tuberculoma from malignancy among non-calcified solitary pulmonary solid nodules

BACKGROUND: Tuberculoma is the most common type of surgically removed benign solid solitary pulmonary nodule (SPN) and can lead to a high risk of misdiagnoses for clinicians. This study aimed to discuss the value of the immunocyte count combined with computed tomography (CT) features in distinguishing pulmonary tuberculoma from malignancy among non-calcified solid SPNs. METHODS: Forty-eight patients with pulmonary tuberculoma and 52 patients with lung cancer were retrospectively included in our study. Univariate and multivariate analyses were conducted to screen the independent predictors. Receiver operating characteristic (ROC) analysis was performed to investigate the validity of the predictive model. RESULTS: The univariate and multivariate analyses revealed that a coarse margin, vacuole, lobulation, pleural indentation, cluster of differentiation (CD)3(+) T-lymphocyte count, and CD4(+) T-lymphocyte count were independent predictors for distinguishing pulmonary tuberculoma from malignancy. The sensitivity, specificity, accuracy, and the area under the ROC curve of the model comprising the CD3(+) T-lymphocyte count were 79.2%, 75%, 74.5%, and 0.845 [95% confidence interval (CI), 0.759–0.910], respectively, and those of the model involving the CD4(+) T-lymphocyte count were 77.1%, 78.8%, 77.1%, and 0.857 (95% CI, 0.773–0.919), respectively. CONCLUSIONS: Immunocyte count combined with CT features is efficient in distinguishing pulmonary tuberculoma from malignancy among non-calcified solid SPNs and has applicable clinical value.