Figure 2: Patient’s Lung Computed Tomography.
Sputum smear and culture, blood, and sputum MTB-PCR were negative but Tc-EMB scintigraphy was positive. According to the patient’s clinical condition and positive scintigraphy, it was decided to prescribe an anti-TB regimen including isoniazid, rifampin, pyrazinamide, and ethambutol along with dexamethasone.
Following the results of the pericardial and myocardial biopsy, the patient was diagnosed with lung adenocarcinoma with massive intra-lung and remote metastasis. According to the new diagnosis, the anti-TB regimen was stopped and chemotherapy was started for the patient. Due to the rarity of the diagnosis in our young patient without any prior risk factor, an immunological study was done which was all negative. The patient’s clinical condition starts to improve after the chemotherapy and he is alive at the moment of writing this article.