Image-guided biopsy-proven lung and skeletal tuberculosis cases mimicking malignancy

Abstract

Aim: Tuberculosis diagnosis may be challenging and percutaneous biopsy may be required for definitive diagnosis. In this study, we aimed to investigate the utility of percutaneous biopsy in diagnosis of tuberculosis and radiological features of the tuberculosis cases diagnosed by image-guided biopsy. Methods: The patients who were diagnosed with tuberculosis by image-guided biopsy between 2016 and 2020 in our institution were reviewed retrospectively in these case series. Histories of malignancy or immune deficiency, age and genders of the patients, localizations and radiological imaging findings of the lesions, needle types, imaging methods used for the biopsies and presumptive diagnoses before the biopsies were noted. Results: A total of 16 patients (5 Females, 11 Males) with a mean age of 41 years (range: 17-74 years) had image-guided biopsy with presumptive diagnosis of infection or malignancy. Four patients had transthoracic core-needle-biopsy for lung masses, 12 had curettage-bone-biopsy for lytic lesions of vertebral and pelvic bones under CT-guidance. Four of the patients had immune deficiency and one had a history of malignancy. All patients were diagnosed with tuberculosis by both histopathological and culture analysis. Conclusion: Image-guided-biopsy is safe and useful in the diagnosis of tuberculosis cases who could not be diagnosed by laboratory and sputum tests or those with presumptive diagnoses of malignancy. Tuberculosis should be kept in mind during percutaneous biopsy of radiologically suspicious cases as a differential diagnosis, even though they are clinically negative.