Meme Kanseri Tanýlý Olguda Endobronþiyal Granülomatöz Lezyon Ayýrýcý Tanýsý

Türkiye’de tüberküloz yaygýn olarak görülmekte olduðundan granülomatöz hastalýklarýn ayýrýcý tanýsýnda mutlaka yer almalýdýr. Tüberküloz etkenini göstermek her zaman mümkün olmadýðýndan tüberküloz ile diðer granülomatöz hastalýklarýn, özellikle de sarkoidozun ve granülomatöz reaksiyon gösteren malignitelerin ayrýmýnda güçlükler yaþanmaktadýr. Burada bu konuya örnek olabilecek primer meme kanseri tanýsý olan bir endobronþiyal granülomatöz iltihap olgusu sunuldu. Meme kanseri tanýsý olan hastanýn toraks görüntülemesinde sol hiler kitle ve mediastinal lenfadenopatiler görüldü. Bu lezyonlar PET-CT’de yüksek tutulum göstermekteydi. Yapýlan biyopsiler sonucu granülomatöz iltihap olarak bulunan hastada malignite ekarte edilmiþ, ancak tüberküloz ekarte edilememiþtir. Bu nedenle immünsupresif tedavi almasý da beklenen hastaya antitüberküloz tedavi baþlanmýþtýr.

Differential Diagnosis of Endobronchial Granulomatous Lesion in Patient with Breast Cancer

Tuberculosis is common in Turkey and must be considered in differential diagnosis of granulomatous diseases. Granulomatous diseases such as sarcoidosis and malignancy are difficult to distinguish from granulomatous reaction of tuberculosis, as it is not always possible to visualize tuberculosis. The aim of the present report was to illustrate this issue in a case of primary breast cancer with endobronchial granulomatous inflammation. Left hilar mass and mediastinal lymphadenopathy were present and showed high uptake in positron-emission tomography and computed tomography (PET–CT). After obtaining biopsies, granulomatous inflammation was diagnosed and malignancy excluded. Nevertheless, tuberculosis could not be excluded. Because the patient was possibly going to receive immunosuppressive treatment, she was placed on antituberculous treatment.