Tuberculous Pleurisy in a Patient with a History of Breast Cancer: Diagnostic Challenges and Management Options

Asel Imankulova (1), Melis Sholpanbai Uulu (2), Elmira Mamytova (3), Nurbek Monolov (4), Tugolbai Tagaev (5)
(1) Department of Surgical Disciplines, Salymbekov University, Bishkek, Kyrgyzstan, Kyrgyzstan,
(2) Department of Infectious Diseases, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan, Kyrgyzstan,
(3) Department of Clinical and Morphological Disciplines, Salymbekov University, Bishkek, Kyrgyzstan, Kyrgyzstan,
(4) Department of Clinical and Morphological Disciplines, Salymbekov University, Bishkek, Kyrgyzstan, Kyrgyzstan,
(5) Department of Hospital Internal Medicine with a course of Hematology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan, Kyrgyzstan

Abstract

Background: Tuberculosis (TB) and cancer are increasingly prevalent diseases that can be challenging to diagnose due to similarities in clinical and radiological findings. This case report describes a 46-year-old woman with a history of breast cancer who developed tuberculous pleurisy (TP). 


Case presentation: A 46-year-old woman who underwent mastectomy and chemotherapy for BC in 2023 had hypertension, but no history of TB. The patient presented with dry cough, fever, and stomach discomfort, with an oxygen saturation level of 60%, but no respiratory distress before their appointment. Microscopy and culture tests were negative for Mycobacterium TB, A positive result was observed with an IFN-γ level of 0.35 IU/ml and 26% of the negative control after TB antigen stimulation. Histological analysis using hematoxylin and eosin staining showed Langhans giant cells, epithelioid cell granulomas, caseous necrosis, and necrotic foci. These findings indicate granulomatous inflammation with no signs of malignancy. Following the diagnosis, the patient received a daily dose of 300 mg isoniazid, 600 mg rifampin, 1500 mg pyrazinamide, and 10 mg pyridoxine for six months without any adverse effects.


Conclusion: Physicians must employ a combination of diagnostic techniques, including morphological and microbiological confirmation, to accurately diagnose pleural effusion in this patient population. 

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Authors

Asel Imankulova
Melis Sholpanbai Uulu
Elmira Mamytova
Nurbek Monolov
Tugolbai Tagaev
ttagaev22kg@gmail.com (Primary Contact)
Author Biographies

Asel Imankulova, Department of Surgical Disciplines, Salymbekov University, Bishkek, Kyrgyzstan

Department of Surgical Disciplines

Melis Sholpanbai Uulu, Department of Infectious Diseases, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan

Department of Infectious Diseases

Elmira Mamytova, Department of Clinical and Morphological Disciplines, Salymbekov University, Bishkek, Kyrgyzstan

Department of Clinical and Morphological Disciplines

Nurbek Monolov, Department of Clinical and Morphological Disciplines, Salymbekov University, Bishkek, Kyrgyzstan

Department of Clinical and Morphological Disciplines

Tugolbai Tagaev, Department of Hospital Internal Medicine with a course of Hematology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan

Department of Hospital Internal Medicine with a course of Hematology

1.
Imankulova A, Uulu MS, Mamytova E, Monolov N, Tagaev T. Tuberculous Pleurisy in a Patient with a History of Breast Cancer: Diagnostic Challenges and Management Options. Arch Breast Cancer [Internet]. [cited 2024 Oct. 3];11(4). Available from: https://www.archbreastcancer.com/index.php/abc/article/view/970

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