Concomitant tuberculosis and lung cancer diagnosed by bronchoscopy

“…Noteworthy, the most common pathogen coinciding with lung cancer is M. tuberculosis . 16 In addition to melioidosis, other rare infections have been reported. The co-existence of endobronchial Talaromyces marneffei and adenocarcinoma has been reported in a 50-year-old healthy woman presenting with one month of chronic cough and prolonged fever.…”

Section: Discussionmentioning

confidence: 99%

<p>Non-Small Cell Lung Carcinoma with Concomitant Localized Pulmonary Melioidosis: A Rare Co-Existing Disease</p>

Laplertsakul

Sutherasan

Suwatanapongched

et al. 2020

IDR

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Melioidosis is caused by Burkholderia pseudomallei, water-and-soil gramnegative bacteria predominantly found in Southeast Asia and Australia. Herein, we reported a 63-year-old Thai man presenting with prolonged fever, non-productive cough, and weight loss for 3 months. He underwent deceased donor kidney transplantation 4 years ago and was on many immunosuppressive agents after transplantation. At presentation, his chest radiograph showed a mass-like lesion in the left upper lobe. Histopathological examination of a transthoracic needle lung biopsy yielded adenocarcinoma, while tissue culture grew for B. pseudomallei. He was diagnosed with stage IIIA non-small cell lung cancer (T4N0M0) co-existing with localized pulmonary melioidosis. After intensive and eradication therapy for melioidosis, his well-being improved with the resolution of fever. He sequentially underwent left upper lobectomy, but the procedure was not accomplished due to severe adhesions surrounding the left lung and great vessels. After surgery, he received concurrent chemoradiation therapy for his lung cancer. Nevertheless, the disease progressed, and he finally passed away. Since fever is not a common manifestation of lung cancer, co-existing infection, such as tuberculosis, fungal infection, and melioidosis, should always be excluded in patients suspected of having lung cancer presenting with unexplained fever.

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“…For patients with positive sputum AFS, the diagnosis revision might be postponed. Because concomitant cancer and infection is not uncommon [25,26], we would not totally exclude mycobacterial infection before we yielded negative cultures for Mycobacterium tuberculosis, which is time consuming [11]. In regard to patients with anti-TB treatment, the diagnosis revision is also late.…”

Section: Discussionmentioning

confidence: 99%

Factors for the Early Revision of Misdiagnosed Tuberculosis to Lung Cancer: A Multicenter Study in A Tuberculosis-Prevalent Area

Chang

Lai

Chang

et al. 2019

JCM

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Background: Lung cancer misdiagnosed as tuberculosis (TB) is not rare, but the factors associated with early diagnosis revision remain unclear. Methods: We screened the cases with TB notification from 2007 to 2018 and reviewed those with misdiagnosis with a revised diagnosis to lung cancer. We analyzed the factors associated with early diagnosis revision (≤1 months) and early obtained pathology (≤1 months) using multivariable Cox regression. Results: During the study period, 45 (0.7%) of 6683 patients were initially notified as having TB, but later diagnosed with lung cancer. The reasons for the original impression of TB were mostly due to image suspicion (51%) and positive sputum acid-fast stain (AFS) (27%). Using multivariable Cox proportional regression, early diagnosis revision was associated with obtaining the pathology early, lack of anti-TB treatment, and negative sputum AFS. Furthermore, the predictors for early obtained pathology included large lesion size (>3 cm), presence of a miliary radiological pattern, no anti-TB treatment, and a culture-negative result when testing for nontuberculous mycobacteria (NTM) using multivariable Cox regression. Conclusion: In patients who are suspected to have TB but no mycobacterial evidence is present, lung cancer should be kept in mind and pathology needs to be obtained early, especially for those with small lesions, radiological findings other than the miliary pattern, and a culture positive for NTM.

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Concomitant tuberculosis and lung cancer diagnosed by bronchoscopy

Cited by 10 publications

References 0 publications

Lung cancer diagnosed with Mycobacterium tuberculosis or nontuberculosis mycobacteria concomitantly

Lung cancer diagnosed with Mycobacterium tuberculosis or nontuberculosis mycobacteria concomitantly

<p>Non-Small Cell Lung Carcinoma with Concomitant Localized Pulmonary Melioidosis: A Rare Co-Existing Disease</p>

Factors for the Early Revision of Misdiagnosed Tuberculosis to Lung Cancer: A Multicenter Study in A Tuberculosis-Prevalent Area

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