Diagnóstico incidental de tuberculosis pulmonar en pacientes remitidos para broncoscopia diagnóstica o seguimiento clínico por enfermedad tumoral maligna: un estudio transversal
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Introducción: La tuberculosis pulmonar incidental se diagnostica inesperadamente en pacientes sin sospecha clínica previa, generalmente durante estudios por otras enfermedades. Existen pocos estudios sobre este tipo de diagnóstico. Describimos las características generales sobre el diagnóstico incidental de tuberculosis pulmonar en pacientes sometidos a broncoscopia por enfermedad neoplásica. Materiales y Métodos: Se llevó a cabo un estudio transversal en pacientes con diagnóstico incidental de tuberculosis pulmonar, identificado durante broncoscopias diagnósticas realizadas a personas con sospecha de cáncer o en seguimiento oncológico. El diagnóstico de tuberculosis se realizó utilizando la técnica GeneXpert MTB/RIF. Resultados: Se incluyó un total de 18 pacientes, con una edad promedio de 50,3 años (DE: 20,4) y predominio de mujeres (55%; 10/18). Las comorbilidades más frecuentes fueron la diabetes mellitus (44%; 8/18) y la hipertensión arterial sistémica (44%; 8/18). El 17% (3/18) de los pacientes había recibido tratamientos oncológicos previos. Los síntomas más comunes asociados a la indicación del procedimiento fueron la pérdida de peso involuntaria (61,1%; 11/18). El 17% (3/18) presentó una prueba de tuberculina positiva, mientras que ninguno mostró baciloscopia positiva. Las tomografías de tórax revelaron infiltrados alveolares/intersticiales en el 50% (9/18), masas en el 28% (5/18), nódulos en el 22% (4/18) y adenopatías en el 28% (5/18). Discusión: La tuberculosis incidental ocurre en pacientes con sospecha de cáncer o en seguimiento oncológico. Es crucial considerar su diagnóstico diferencial en los estudios de broncoscopia.
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