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.