Silico-Tuberculosis Mimicking Malignancy.

ABSTRACT

Silico-tuberculosis is the combination of silicosis and tuberculosis (TB). Symptoms of TB such as dyspnea, cough, and hemoptysis may precede the diagnosis of an endo-bronchial mass lesion on chest imaging. Among workers who were exposed to silica, TB was more common, and experiments indicated that silica inhibits alveolar macrophage activity and severe exposure induces apoptosis. Endobronchial neoplasms, which are tumors primarily affecting the bronchial lumen, are uncommon and may show up in a wide variety of different ways pathologically. Cough, chest discomfort, wheezing, hemoptysis, recurrent pneumonia, and weight loss are common complaints from people with endobronchial tumors. The requirement for additional bronchoscopy and imaging examination is raised when symptoms such as hemoptysis and obstructive pneumonia are present. Endobronchial silicosis lesions are uncommon and develop as a result of broncho lithiasis, the endoluminal erosion of peri bronchial adenopathy, or local bronchial wall silica-induced fibrosis. Endobronchial TB can present in a varied manner, diagnosis is often challenging as there is no specific radiological feature, and sputum acid-fast bacilli several times come out negative. However, a bronchoscopy with or without biopsy is a useful investigation in these cases. The following case is a rare manifestation of endobronchial TB as it mimicked malignancy, describing the difficulties in diagnosis and treating a patient who had both silicosis and endobronchial TB.