Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2023; 11(22): 5365-5372
Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5365
Individual with concurrent chest wall tuberculosis and triple-negative essential thrombocythemia: A case report
Xiao-Yan Xu, Yong-Bin Yang, Jun Yuan, Xiao-Xia Zhang, Lin Kang, Xiang-Shu Ma, Jie Yang
Xiao-Yan Xu, Jun Yuan, Xiao-Xia Zhang, Jie Yang, Department of Haematology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
Xiao-Yan Xu, Graduate School, Hebei North University, Zhangjiakou 075000, Hebei Province, China
Yong-Bin Yang, Department of Vascular Surgery, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
Lin Kang, Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
Xiang-Shu Ma, Clinical Laboratory, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
Author contributions: Xu XY, Yang YB, Yuan J, and Zhang XX, contributed to manuscript writing and editing, and data collection; Kang L and Ma XS contributed to data analysis; Yang J contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent for this case report has been obtained from the patient.
Conflict-of-interest statement: The authors report no conflicts of interest in this work.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie Yang, Doctor, Associate Professor, Department of Haematology, Hebei General Hospital, No. 348 Heping West Road, Shijiazhuang 050051, Hebei Province, China. yjyyb313@163.com
Received: April 23, 2023
Peer-review started: April 23, 2023
First decision: June 15, 2023
Revised: June 25, 2023
Accepted: July 17, 2023
Article in press: July 17, 2023
Published online: August 6, 2023
Abstract
BACKGROUND

Chest wall tuberculosis (TB) and triple-negative essential thrombocythemia (TN-ET) are rare medical conditions, and their combination is extremely rare globally. Only one case of TB peritonitis with thrombocytosis has been reported, which was identified in 1974.

CASE SUMMARY

Herein, we report the case of a 23-year-old man with concurrent chest wall mass and TN-ET. The patient presented to a local hospital due to having a headache and low-grade fever for 2 d, with their bodily temperature fluctuating at around 36.8 °C. Hematological analysis showed a high platelet count of 1503 × 109/L. Subsequently, the patient visited our hospital for further investigation. Computed tomography of the chest suggested a submural soft tissue density shadow in the left lower chest wall. After surgical resection, the pathological findings of the swelling were reported as TB with massive caseous necrosis. According to the World Health Organization diagnostic criteria, the patient was diagnosed with TN-ET, as they met the requirement of four main criteria or the first three main criteria and one secondary criterion. The patient was eventually diagnosed with chest wall TB with TN-ET, which is extremely rare.

CONCLUSION

Chest wall TB is rare. TN-ET diagnosis requires secondary factor exclusion and satisfaction of primary diagnostic criteria. miRNA, combined with the methylation process, could explain suppressor of cytokine signaling (SOCS) 1 and SOCS3 downregulation in ET-JAK2V617F-negative patients. The miRNA could participate in JAK2 pathway activation. SOCS3 may be a novel MPN biomarker.

Keywords: Platelet, Thrombocythemia, Triple-negative, Chest wall tuberculosis, SOCS3 gene, JAK-STAT pathway, Case report

Core Tip: Essential thrombocythemia (ET) is a myeloproliferative neoplasm (MPN) disorder resulting from genetic mutations in one or more common oncogenes. Here, we report the case of a 23-year-old male patient with a chest wall mass and extremely high platelet count, which remained extremely high even after surgical excision of the chest wall mass, chest wall tuberculosis (TB) diagnosis, and anti-TB combinatory drug therapy. Suppressor of cytokine signaling may be a novel MPN biomarker. Concurrent triple-negative ET and chest wall TB is uncommon, and its pathogenesis requires investigation.