Case Report: tuberculous pleurisy mimicking mesothelioma in a 37-year-old Chinese woman

Tuberculosis is a great mimicker of infectious as well as non-infectious diseases, such as cancer. Tuberculous pleurisy is one of the most common extrapulmonary tuberculosis manifestations, and it is difficult to diagnose. We describe a case of tuberculous pleurisy presenting with diffuse bilateral pleural thickening. This 37 year old woman had 1-year history of intermittent shortness of breath for which CT thorax was obtained at community hospital that showed bilateral pleural thickening. Increased fluorodeoxyglucose uptake along nodular bilateral pleural thickenings and in the hilar lymph nodes mimicked mesothelioma. Subsequent acid-fast staining of the pleural biopsy specimen was positive. The patient received antituberculosis therapy for 6 months, with clearly improved pleural lesions on chest computed tomography. In relatively young individuals presenting with diffuse pleural thickening, even when there are minimal intermittent subjective symptoms, the possibility of tuberculosis should not be ignored.