Asymptomatic Tuberculous Pleurisy Mimicking Mesothelioma

A case study of a 26-year-old woman, with no medical history, was referred to a hospital following abnormal chest X-ray findings were pointed out in a routine health checkup at her work as a community hospital nurse. The patient was asymptomatic and was not receiving any supplements or medications. She had never drunk alcohol nor smoked. Her immune status was normal, and tests negative for both HIV and human T-cell leukemia virus type 1. Chest computed tomography revealed diffuse irregular left pleural thickening and mediastinal and hilar lymphadenopathy. On the basis of the characteristic imaging findings, mesothelioma or pseudomeso-theliomatous carcinoma were suspected. Ultrasonography-guided transthoracic needle biopsy of the left pleural lesions revealed epithelioid cell granuloma. Acid-fast staining of the specimen and PCR for tubercubsis were both positive. A T-SPOT.TB test was added, and the result was positive. Thus, antituberculosis therapy was initiated. On the basis of these findings, the patient was diagnosed with tuberculous pleurisy with bronchial tuberculosis and Iymphadenitis.