Journal of investigative medicine high impact case reports最新文献_第2页

Unusual Thromboembolic Sequelae of MRSA Bacteremia in A Pediatric Patient: A Case Report. 小儿MRSA菌血症异常血栓栓塞后遗症1例报告。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-04-06 DOI: 10.1177/23247096261440355

Shahd Khatib, Omer Innab, Nardeen Hammad, Adel Rajab, Shahd Al-Aloul, Miar Haj-Abdalrahman, Aysha Masri

{"title":"Unusual Thromboembolic Sequelae of MRSA Bacteremia in A Pediatric Patient: A Case Report.","authors":"Shahd Khatib, Omer Innab, Nardeen Hammad, Adel Rajab, Shahd Al-Aloul, Miar Haj-Abdalrahman, Aysha Masri","doi":"10.1177/23247096261440355","DOIUrl":"10.1177/23247096261440355","url":null,"abstract":"Methicillin-resistant Staphylococcus aureus infection can cause serious illness in children. It can progress to life-threatening bloodstream issues or bone infections, including: deep vein thrombosis, septic pulmonary embolism, toxic shock syndrome, and osteomyelitis. Treatment depends on control of infection with adequate antibiotics and early anticoagulation. We present a case of a 11-year old male child who presented with left arm and right leg pain and swelling that was associated with fever. However, there was no history of trauma. Blood culture was taken and showed Methicillin-resistant Staphylococcus aureus growth. Initial ultrasound of the affected limbs was unremarkable except for subcutaneous edema. On the following day, ultrasound of the affected limbs was consistent with deep vein thrombosis. Additionally, the patient developed pleuritic chest pain and a computed tomography scan with pulmonary angiography demonstrated a filling defect in the left upper segmental artery suggesting septic pulmonary embolism. Magnetic resonance imaging of the lower limbs was recommended and it suggested the diagnosis of osteomyelitis. Ultrasound guided drainage was done and the patient was treated with appropriate antibiotics and enoxaprine. Multifocal thromboembolic events with osteomyelitis in an immunocompetent child are rare and clinically important. This case highlights the complex nature of methicillin-resistant Staphylococcus aureus infection in pediatrics and emphasizes the value of early imaging and multidisciplinary collaboration to establish an accurate diagnosis and a good clinical outcome. Awareness of such presentations can facilitate earlier diagnosis and intervention, to reduce the risk of complications in pediatric patients.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096261440355"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Rare Pediatric Paratesticular Spindle Cell Rhabdomyosarcoma and Systematic Literature Review. 1例罕见小儿睾丸旁梭形细胞横纹肌肉瘤及系统文献回顾。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.1177/23247096251415447

Gevara Arja, Omar Hammam Salloum, Jamal Jaber, Tala Jubah, Sumaya Alrjoub, Taghreed Imran, Asma Alrjoub, Ammar W M Hassouneh, Motaz Natsheh

{"title":"A Rare Pediatric Paratesticular Spindle Cell Rhabdomyosarcoma and Systematic Literature Review.","authors":"Gevara Arja, Omar Hammam Salloum, Jamal Jaber, Tala Jubah, Sumaya Alrjoub, Taghreed Imran, Asma Alrjoub, Ammar W M Hassouneh, Motaz Natsheh","doi":"10.1177/23247096251415447","DOIUrl":"10.1177/23247096251415447","url":null,"abstract":"Paratesticular rhabdomyosarcoma (RMS) is a rare malignancy, representing ~3% of all pediatric soft tissue tumors. The spindle cell subtype, a variant of embryonal RMS, is particularly uncommon but is typically associated with a favorable prognosis. We report the case of a 12-year-old boy who presented with a painless, progressively enlarging right inguinoscrotal mass. Imaging studies revealed a heterogeneous lesion without distant metastasis, and tumor markers were within normal limits. The patient underwent radical orchiectomy, and histopathology confirmed spindle cell RMS, with immunohistochemical positivity for myogenin and desmin. After completing treatment with the Children's Oncology Group (COG)-ARST0531 Vincristine, Actinomycin D, and Cyclophosphamide protocol, a retroperitoneal lymph node recurrence was detected 1 year later. Management consisted of surgical resection and escalated chemotherapy per the COG-ARST0431 protocol, with subsequent imaging showing no evidence of disease. This case demonstrates that despite a favorable histology, paratesticular spindle cell RMS carries a risk of late, regional recurrence, underscoring the necessity of vigilant long-term surveillance. We also performed a systematic literature review to contextualize our findings, focusing on clinical presentation, therapeutic strategies, and outcomes.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096251415447"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Rare Paratesticular Leiomyosarcoma Presenting as a Painless Scrotal Mass in an Elderly Patient: A Case Report. 罕见睾丸旁平滑肌肉瘤表现为无痛性阴囊肿块1例。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-02-25 DOI: 10.1177/23247096261420891

Marvin A Simpkins, Garrett Douglas, Dominic M Collins, Aishniya Kandula, Darshan Sangani, Roger Robertson

{"title":"A Rare Paratesticular Leiomyosarcoma Presenting as a Painless Scrotal Mass in an Elderly Patient: A Case Report.","authors":"Marvin A Simpkins, Garrett Douglas, Dominic M Collins, Aishniya Kandula, Darshan Sangani, Roger Robertson","doi":"10.1177/23247096261420891","DOIUrl":"10.1177/23247096261420891","url":null,"abstract":"Leiomyosarcomas (LMS) are malignant tumors originating from smooth muscle and rarely found in the scrotum. LMS has an insidious presentation that is often misdiagnosed as a benign lesion. This report outlines an innocuous case of paratesticular leiomyosarcoma while focusing on the diagnosis and treatment paratesticular LMS. We report the case of an 84-year-old male who presented with a painless left scrotal swelling of 5 days' duration. Imaging and tumor markers suggested a paratesticular mass suspicious for malignancy. Surgical excision revealed a Fédération Nationale des Centres de Lutte Contre le Cancer Grade 2 leiomyosarcoma arising from the scrotal soft tissue, confirmed by positive smooth muscle markers on immunohistochemistry. Postoperative imaging demonstrated no recurrence at 8 months. This case highlights the diagnostic challenge of paratesticular leiomyosarcoma and the importance of surgical resection and careful follow-up for optimal patient outcomes.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096261420891"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Expanding the Phenotypic Spectrum of SLC1A4-Related Spastic Tetraplegia: A Case With Novel Multisystem Features. 扩展slc1a4相关的痉挛性四肢瘫痪的表型谱：一个具有新的多系统特征的病例。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-04-03 DOI: 10.1177/23247096261440338

Ramzi H Mujahed, Leyana Alawawdeh, Baraa Nassar, Ranya Abu Khalaf, Adam Hafiz Qabaha, Taha Z Makhlouf

{"title":"Expanding the Phenotypic Spectrum of SLC1A4-Related Spastic Tetraplegia: A Case With Novel Multisystem Features.","authors":"Ramzi H Mujahed, Leyana Alawawdeh, Baraa Nassar, Ranya Abu Khalaf, Adam Hafiz Qabaha, Taha Z Makhlouf","doi":"10.1177/23247096261440338","DOIUrl":"10.1177/23247096261440338","url":null,"abstract":"Spastic tetraplegia, thin corpus callosum, and progressive microcephaly (SPATCCM) is a rare autosomal recessive neurodevelopmental disorder caused by pathogenic variants in the SLC1A4 gene. 24 cases have been reported worldwide. We describe a 30-month-old boy born to consanguineous parents, presenting with global developmental delay, seizures, progressive microcephaly, spastic tetraplegia, feeding difficulties, and recurrent infections. Genetic testing confirmed a homozygous pathogenic variant in SLC1A4 (p.Arg457Trp). Notably, our patient exhibited novel systemic phenotypic features, including grade 2 finger clubbing, recurrent infections, bilateral hernias, meatal stenosis, and dysmorphic features (high-arched palate, low-set ears, pectus carinatum). Brain MRI demonstrated a diffusely thin corpus callosum, a typical finding consistent with the classic SPATCCM phenotype. These previously unreported systemic features broaden the recognized phenotypic spectrum and underscore the need for genetic testing in suspected cases.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096261440338"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Case Report: Spontaneous Tumor Lysis Syndrome in a Patient With Cholangiocarcinoma. 一例胆管癌患者的自发肿瘤溶解综合征。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-03-23 DOI: 10.1177/23247096251407832

Maria A Lasprilla-Pallares, Jorge C Nakazaki, Jairo A Rivera-Castro

{"title":"Case Report: Spontaneous Tumor Lysis Syndrome in a Patient With Cholangiocarcinoma.","authors":"Maria A Lasprilla-Pallares, Jorge C Nakazaki, Jairo A Rivera-Castro","doi":"10.1177/23247096251407832","DOIUrl":"10.1177/23247096251407832","url":null,"abstract":"Tumor lysis syndrome (TLS) consists of a rapid tumor cell breakdown that ends in multiple metabolic derangements and can occur spontaneously or be triggered by oncological therapies. It is a serious oncological emergency, primarily seen in hematological malignancies like non-Hodgkin lymphomas and particularly Burkitt's lymphoma, as well as in certain bulky solid tumors like neuroblastoma. This report discusses a case of spontaneous TLS in a patient with metastatic cholangiocarcinoma. We present a case of a 72-year-old Hispanic male with a history of hypertension, tobacco use disorder, and alcoholism who was admitted for 20 days of worsening abdominal distention, edema, dyspnea, cough, and hyporexia. Physical examination revealed jaundice and signs of ascites. Laboratory studies showed mildly elevated liver enzymes and a resolved hepatitis B infection. A multiphase computerized tomography (CT) scan of the abdomen revealed a large heterogeneous hepatic mass, ascites, lymphadenopathy, and portal vein thrombosis. Chest CT showed nodules with perilymphatic distribution. A paracentesis yielded 3000 cc of ascitic fluid, showing a serum-ascites albumin gradient of 1.81 g/dL and neutrophil predominance. Tumor markers indicated elevated CA 19-9 levels. Subsequent liver biopsy confirmed moderately differentiated adenocarcinoma, and the immunohistochemistry supported a diagnosis of cholangiocarcinoma. On day 5 of hospitalization, the patient's renal function worsened, leading to spontaneous TLS. Overall, TLS is a life-threatening emergency in cancer patients, necessitating regular lab tests for early diagnosis, especially in those on chemotherapy or with known solid tumors. There is no consensus on diagnosing spontaneous TLS.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096251407832"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pulmonary Embolism Presenting as Backache After Appendectomy: An Atypical Presentation of a Common Diagnosis. 阑尾切除术后表现为背痛的肺栓塞：一种常见诊断的非典型表现。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-02-28 DOI: 10.1177/23247096261429177

Songjun Shao, Yujun Wang, Xiaoju Tang, Fengming Luo

引用次数: 0

Unmasking Diffuse Large B-Cell Lymphoma: A Challenging Case of Acute Cardiac Tamponade in the Setting of Right-Sided Heart Mass Invasion. 弥漫性大b细胞淋巴瘤：右侧心脏肿块侵袭急性心包填塞的一例挑战。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-02-24 DOI: 10.1177/23247096261419226

Rouba Isshak, Aqsa Sorathia, Hasan Munshi, Alaa Musallam, Nagihan Orhun, Abraam Rezkalla, Sacide S Ozgur, Abdullah Sultan Ahmad, Yezin F Shamoon, Fayez Shamoon

{"title":"Unmasking Diffuse Large B-Cell Lymphoma: A Challenging Case of Acute Cardiac Tamponade in the Setting of Right-Sided Heart Mass Invasion.","authors":"Rouba Isshak, Aqsa Sorathia, Hasan Munshi, Alaa Musallam, Nagihan Orhun, Abraam Rezkalla, Sacide S Ozgur, Abdullah Sultan Ahmad, Yezin F Shamoon, Fayez Shamoon","doi":"10.1177/23247096261419226","DOIUrl":"10.1177/23247096261419226","url":null,"abstract":"Cardiac metastases, particularly those originating from non-Hodgkin lymphoma, are often underdiagnosed and represent a rare but critical manifestation of advanced cancer. This case report discusses a 57-year-old female with a history of hypertension who initially presented with symptoms of cardiac tamponade, leading to the discovery of a large cardiac mass, ultimately diagnosed as diffuse large B-cell lymphoma following a cytological examination of the pericardial fluid and lymph node biopsy. Further imaging, including echocardiography and computed tomography scans, showed extensive metastasis to the pericardium, mediastinum, and other areas, such as the thyroid and peritoneum. Despite the prompt initiation of management, the patient suffered a massive pulmonary embolism, highlighting the poor prognosis associated with metastatic cardiac lymphoma. This case underscores the importance of bedside echocardiography as a rapid initial method for identifying cardiac tamponade, as well as maintaining a high index of suspicion for hematologic malignancies in patients presenting with unexplained pericardial effusions. It emphasizes the need for comprehensive diagnostic approaches and multidisciplinary management to improve patient outcomes in this rare and challenging clinical scenario.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096261419226"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12932876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional Recovery Following Intensive Upfront Therapy in Multiple Myeloma Patients With Poor Performance Status: A Case Series. 对表现不佳的多发性骨髓瘤患者进行强化前期治疗后的功能恢复：一个病例系列。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-04-27 DOI: 10.1177/23247096261446475

Kareem Latif, Jerry Qi, Pranati Shah, Mojtaba Akhtari

{"title":"Functional Recovery Following Intensive Upfront Therapy in Multiple Myeloma Patients With Poor Performance Status: A Case Series.","authors":"Kareem Latif, Jerry Qi, Pranati Shah, Mojtaba Akhtari","doi":"10.1177/23247096261446475","DOIUrl":"10.1177/23247096261446475","url":null,"abstract":"Patients with newly diagnosed multiple myeloma (MM) may present with profound functional impairment due to high disease burden, and an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 4 is often viewed as a barrier to intensive therapy despite potential reversibility. We report six newly diagnosed, bedbound MM patients (ECOG 4) treated with individualized multi-agent regimens incorporating proteasome inhibitors, immunomodulatory agents, and anti-CD38 monoclonal antibodies when feasible. Advanced features included extensive skeletal disease, renal dysfunction, hyperviscosity, and high-risk cytogenetics. All patients demonstrated rapid biochemical response, with a median M-protein reduction of approximately 75%; five of six achieved a very good partial response or better, including one complete response. Functional recovery paralleled depth of response, with a median time to meaningful improvement of 10 weeks. All patients improved to ECOG 2 or better, regaining ambulation and independence in activities of daily living. One patient proceeded to autologous stem cell transplantation and another completed stem cell mobilization. No irreversible treatment-limiting toxicities were observed. These findings suggest that severe functional impairment at presentation often reflects reversible disease burden and that aggressive, individualized therapy can result in substantial clinical and functional recovery in patients initially considered too debilitated for intensive treatment.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096261446475"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case Report of Thrombocytopenia Caused by a May-Hegglin Anomaly in a Young Saudi Female. 一例沙特年轻女性May-Hegglin异常引起的血小板减少症。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-02-21 DOI: 10.1177/23247096261425195

Rehab Y Al-Ansari, Rawan Rashed Aljohani, Rayan Mansour Aljurbua, Ali Mohammed Alasmari, Muhammad F Abdellatif, Nawaf Zakary

{"title":"A Case Report of Thrombocytopenia Caused by a May-Hegglin Anomaly in a Young Saudi Female.","authors":"Rehab Y Al-Ansari, Rawan Rashed Aljohani, Rayan Mansour Aljurbua, Ali Mohammed Alasmari, Muhammad F Abdellatif, Nawaf Zakary","doi":"10.1177/23247096261425195","DOIUrl":"10.1177/23247096261425195","url":null,"abstract":"Low platelet count is rarely caused by inherited thrombocytopenia. May-Hegglin anomaly is an uncommon condition that falls under the umbrella of familial thrombocytopenia. The condition is under-reported in Saudi Arabia; therefore, we report the current case. This is a 24-year-old Saudi lady, presented to the emergency room with vaginal bleeding. No bleeding occurred at any other sites. She has a positive family history of thrombocytopenia among her father and 2 of her siblings. Her platelet count was 16 × 103/µL with normal other blood count as well as renal and liver panels. She was admitted to the regular bed for investigation as sever thrombocytopenia with suspicion of either familial or immune thrombocytopenia. Further studies showed normal hemostatic, virology, and connective tissue disease markers. Peripheral blood film showed low platelet distribution with occasional large/giant platelets and basophilic inclusion bodies in some neutrophils (Dohle body-like). A picture suggestive of May-Hegglin related thrombocytopenia that was confirmed by the presence of a positive myosin heavy chain 9 (MYH9) gene mutation. In conclusion, there are many difficulties in diagnosing and treating May-Hegglin disorders in females of reproductive age. More research and guidelines are needed to manage inherited thrombocytopenia before and throughout pregnancy.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096261425195"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tuberculosis Presenting as Multiple Pulmonary Nodules Mimicking Malignancy. 肺结核表现为多发性肺结节，类似恶性肿瘤。

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Journal of investigative medicine high impact case reports Pub Date : 2026-01-01 Epub Date: 2026-03-04 DOI: 10.1177/23247096261429205

Abdel Martinez, Fatimah Bello, Brandon Cantazaro, Luisa Montoya, Frank Mendiola

{"title":"Tuberculosis Presenting as Multiple Pulmonary Nodules Mimicking Malignancy.","authors":"Abdel Martinez, Fatimah Bello, Brandon Cantazaro, Luisa Montoya, Frank Mendiola","doi":"10.1177/23247096261429205","DOIUrl":"10.1177/23247096261429205","url":null,"abstract":"Multiple pulmonary nodules often raise concern for metastatic malignancy; however, the differential diagnosis is broad and includes infectious, inflammatory, granulomatous, vascular, and benign etiologies. Tuberculosis (TB), although uncommon, can present with multiple nodules that closely mimic metastatic disease on advanced imaging, requiring careful clinicoradiologic and microbiologic correlation. We describe a woman in her 50s who presented with dyspnea and new-onset heart failure, in whom imaging revealed mediastinal lymphadenopathy and bilateral pulmonary nodules concerning for malignancy. Evaluation was limited by concurrent COVID-19 infection, and CT-guided biopsy demonstrated necrotizing granulomas without evidence of malignancy or infection. She later re-presented with fever and productive cough, with imaging showing progression to cavitary lung lesions. Bronchoscopy was deferred due to high procedural risk, and sputum studies ultimately confirmed pulmonary TB by positive AFB smear and MTB PCR. She was started on standard antituberculous therapy and discharged with directly observed treatment. This case highlights the importance of maintaining a broad differential diagnosis when evaluating multiple pulmonary nodules and emphasizes the role of microbiologic testing in establishing the diagnosis when invasive procedures are not feasible.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"14 ","pages":"23247096261429205"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0