Tuberculosis Misdiagnosed as Bronchogenic Carcinoma: A Case Report

The patient, a 77-year-old male smoker, presented to the Emergency Department with dyspnea, cough, fever, night sweats, and 12 kg weight loss, initially suggesting COPD or lung cancer. Chest CT revealed a right upper lobe mass, pleural effusion, and lymphadenopathy, prompting suspicion of malignancy. Bronchoalveolar lavage was negative for acid-fast bacilli (AFB), and abdominal/pelvic CT showed no metastases. Transthoracic biopsy confirmed pulmonary TB with caseating granulomas and AFB, with no evidence of malignancy. A 6-month anti-TB regimen resolved all symptoms and lesions.