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Yeungnam Univ J Med > Volume 32(1); 2015 > Article
Yeungnam University Journal of Medicine 2015;32(1):50-54.
DOI:    Published online June 30, 2015.
Malignant mesothelioma mistaken for tuberculous pleurisy.
Ji Young Yang, Min Joo Song, So Jung Park, Jaekyung Cheon, Jung Wan Yoo, Chang Min Choi, Yong Hee Kim
1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
2Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Malignant mesothelioma is a common, primary tumor that can invade pleura, and is associated with previous exposure to asbestos. However, it poses considerable difficulties regarding its diagnosis and treatment, and thus, accurate history taking with respect to exposure to asbestos, and radiologic and pathologic examinations are essential. In addition, the involvement of a multidisciplinary team is recommended in order to ensure prompt and appropriate management using a framework based on radiotherapy, chemotherapy, surgery, and symptom palliation with end-of-life care. Because lymphocyte-dominant, exudative pleural effusion can occur in malignant mesothelioma, adenosine deaminase values may be elevated, which could be mistaken for tuberculous pleurisy, and lead to an incorrect diagnosis and suboptimal treatment. The authors describe a case of malignant mesothelioma initially misdiagnosed as tuberculous pleurisy. As evidenced by the described case, malignant mesothelioma should be considered during the differential diagnosis of patients with lymphocyte-dominant, exudative pleural effusion with a pleural lung lesion.
Key Words: Malignant mesothelioma, Adenosine deaminase, Pleural tuberculosis
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