Tuberculosis Infected T Lymphocyte Spot as a Differential Diagnosis of Pulmonary Tuberculosis and Choriocarcinoma Recurrence: A Case Report and Review of the Literature  

作　　者：Qi Wu Zhaoping Chu Jun Dai Ligang Jia Xinling Wang Lihui Li Jie Li Yuan Zhang Ping Yan Jianxiang Hou Qi Wu;Zhaoping Chu;Jun Dai;Ligang Jia;Xinling Wang;Lihui Li;Jie Li;Yuan Zhang;Ping Yan;Jianxiang Hou(Department of Gynaecology, Hebei General Hospital, Shijiazhuang, China;Department of Immunology and Pathobiology, Hebei University of Chinese Medicine, Shijiazhuang, China;Department of Gynaecology, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China)

机构地区：[1]Department of Gynaecology, Hebei General Hospital, Shijiazhuang, China [2]Department of Immunology and Pathobiology, Hebei University of Chinese Medicine, Shijiazhuang, China [3]Department of Gynaecology, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China

出　　处：《Journal of Biosciences and Medicines》2023年第9期31-36,共6页生物科学与医学（英文）

摘　　要：Introduction: Choriocarcinoma is an aggressive tumor, whose incidence is 0.18 per 100,000 women between the ages of 15 and 49 years [1]. Although its prognosis has improved with the development of chemotherapy regimens, the mortality rate of patients with brain metastases is reportedly 29.7% [2]. After chemotherapy, most often, the reappearance of masses in pulmonary is considered to be a sign of relapse. Case presentation: The patient was a 32-year-old Asian Chinese female who delivered a dead male infant at 33 weeks gestation. The placenta appeared to be normal. The major presentation was a haemorrhage of the vagina. The patient received combined treatment with systematic multi-agent chemotherapy and whole-brain radiation therapy at the General Hospital of Hebei Province and achieved complete remission. Two years after remission, a chest CT scan revealed a mass in the right lung that had become larger over 6 months. The patient’s serum β-human chorionic gonadotropin (β-HCG) level was normal, and the tuberculosis infected T lymphocyte spot (T-SPOT.TB) tests were positive. The patient was started on anti-tuberculosis therapy, after which the size of her right lung mass decreased. Conclusion: Lung masses after choriocarcinoma require extensive laboratory and imaging exams to exclude recurrence. This case highlights the importance of differential diagnoses of lung masses in patients with choriocarcinomas. Imaging studies, β-HCG and local lesion resection should be employed to rule out choriocarcinoma recurrence.Introduction: Choriocarcinoma is an aggressive tumor, whose incidence is 0.18 per 100,000 women between the ages of 15 and 49 years [1]. Although its prognosis has improved with the development of chemotherapy regimens, the mortality rate of patients with brain metastases is reportedly 29.7% [2]. After chemotherapy, most often, the reappearance of masses in pulmonary is considered to be a sign of relapse. Case presentation: The patient was a 32-year-old Asian Chinese female who delivered a dead male infant at 33 weeks gestation. The placenta appeared to be normal. The major presentation was a haemorrhage of the vagina. The patient received combined treatment with systematic multi-agent chemotherapy and whole-brain radiation therapy at the General Hospital of Hebei Province and achieved complete remission. Two years after remission, a chest CT scan revealed a mass in the right lung that had become larger over 6 months. The patient’s serum β-human chorionic gonadotropin (β-HCG) level was normal, and the tuberculosis infected T lymphocyte spot (T-SPOT.TB) tests were positive. The patient was started on anti-tuberculosis therapy, after which the size of her right lung mass decreased. Conclusion: Lung masses after choriocarcinoma require extensive laboratory and imaging exams to exclude recurrence. This case highlights the importance of differential diagnoses of lung masses in patients with choriocarcinomas. Imaging studies, β-HCG and local lesion resection should be employed to rule out choriocarcinoma recurrence.

关 键 词：CHORIOCARCINOMA TUBERCULOSIS 

分 类 号：R73[医药卫生—肿瘤]