Reactivation of Pulmonary Tuberculosis in Malignancy

Karnak, Demet; Kayacan, Oya; Beder, Sumru

doi:10.1177/030089160208800313

Cited by 40 publications

(41 citation statements)

References 15 publications

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“…Furthermore, several studies were excluded because they expressed TB cases among cancer patients as a proportion (cumulative incidence) rather than an incidence rate, with no adjustment for the time at risk [16,37,38]. Two studies were excluded after full-text review because they reported the risk of TB in cancer patients with an increased pre-test probability of having TB (based on the assessment of clinicians [39] or chest radiographic abnormalities suspicious for TB [40]). Another study was excluded because TB was diagnosed simultaneously with cancer in the majority of cases [41].…”

Section: Study Characteristicsmentioning

confidence: 99%

Risk of tuberculosis in patients with solid cancers and haematological malignancies: a systematic review and meta-analysis

et al. 2017

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There is uncertainty regarding whether patients with cancer should be screened for latent tuberculosis infection (LTBI). We performed a systematic review and meta-analysis to estimate the relative incidence of tuberculosis (TB) in cancer.We searched MEDLINE and Embase for studies published before December 21, 2016. We included studies that evaluated the incidence of TB in patients with solid cancers and haematological malignancies relative to a reference group (study control or general population). A pooled estimate of the incidence rate ratio (IRR) was obtained using standard meta-analysis methods.The search strategy identified 13 unique studies including 921 464 patients with cancer. The IRR of TB for adult patients with cancer was 2.61 (95% CI 2.12-3.22; I 2 =91%). In haematological cancers, the IRR was 3.53 (95% CI 1.63-7.64; I 2 =96%); and in solid cancers in adults, it was 2.25 (95% CI 1.96-2.58; I 2 =91%). The highest IRR was found in children with haematological malignancies or solid cancers (IRR 16.82,; I 2 =79%). Considering the limited duration of maximum immunosuppression in cancer and reduced cumulative lifetime risk of TB because of reduced life expectancy, children, but not adults, appear to be at a sufficient level of risk to warrant systematic screening for LTBI.

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Section: Study Characteristicsmentioning

confidence: 99%

Risk of tuberculosis in patients with solid cancers and haematological malignancies: a systematic review and meta-analysis

et al. 2017

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“…The incidences of TB and LC are 24/100,000 and 81.6/100,000, respectively (21,22). In a previous prospective study from Turkey, including 73 patients (66 LC, seven other malignancies) who had undergone fiberoptic bronchoscopy, the incidence of active TB was found to be 8% (n=6), which was diagnosed via routine bronchial washing and/or post-bronchoscopic sputum cultures (23). In a study including 1111 LC patients in a medical center in Taiwan, TB was the third most common comorbidity with a ratio of 9.7% following hypertension and diabetes mellitus (24).…”

Section: Discussionmentioning

confidence: 99%

Is Tuberculosis a Challenge in the Management of Lung Cancer?

Köksal¹,

Kızılgöz²,

Özcan³

et al. 2017

Eurasian J Pulmonol

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Objective: The coincidence of tuberculosis (TB) and lung cancer (LC) at the initial diagnosis or the development of TB during the course of LC is a challenge in the management of both diseases. Herein we reviewed 10 LC patients who coincidentally had TB and evaluated the challenges in the management of both diseases. Methods:The files of patients were retrieved from an archive, and available study forms were completed. Results:The study included 10 LC and TB patients during a 4 year-period. The sites of TB were the lung (seven patients), mediastinal lymph nodes (LN) (one patient), cervical LN (one patient), and subcutaneous nodules (one patient). LC and TB were simultaneously diagnosed in four patients. The diagnosis of pulmonary TB was confirmed by sputum culture two months after LC diagnosis in four patients. TB was diagnosed later in the follow-up period in two patients. Only one patient with early-stage LC who had undergone surgical resection tolerated anti-TB therapy well. In one patient, TB caused the over-staging of LC. In one patient, LC had progressed during the course of anti-TB therapy. Hepatotoxicity was the leading adverse reaction due to anti-TB therapy. Conclusion:These patients highlighted the importance of considering TB in the course of LC, especially in countries with a high TB prevalence. TB may cause the advanced staging of LC at the initial diagnosis; chemotherapy may worsen the TB course or cause reactivation TB. Reactivation TB may be considered as the progression of LC without tissue diagnosis or sputum analysis. The tolerability of anti-TB therapy is poor in these patients.

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“…Karnak et al have described the coexistence of pulmonary TB in patients with lung carcinoma; in this situation, the radiological findings of either disease can mimic the other. 2 Other cases have been reported of concurrent breast cancer and axillary tuberculous lymphadenopathy. 8 In such cases, microscopic detection of acid-fast bacilli by Ziehl -Nielson staining has been found to be insufficiently sensitive to confirm the histopathological diagnosis; the use of polymerase chain reaction based assays has been suggested as a fast, cheap and reliable alternative.…”

Section: Discussionmentioning

confidence: 99%

“…1 There is a well known association between tuberculosis and malignancy, with cancer patients having a nine times greater risk of developing tuberculosis (TB) compared with the general population. 2,3 Immunological studies have increased our understanding of this association; the process of carcinomatosis has been shown to exert immunosuppressive effects extending from the primary tumour site to secondary lymphoid organs and peripheral vessels. 4 This is mediated by tumour-derived soluble factors such as interleukin-10, transforming growth factor-b and vascular endothelial growth factor.…”

Section: Introductionmentioning

confidence: 99%

Tuberculous cervical lymphadenitis in a patient with laryngeal carcinoma

Al-Zahid

Singh

2009

J. Laryngol. Otol.

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To our knowledge, this is the first report of a laryngeal carcinoma with concurrent tuberculous cervical lymphadenitis. In the face of an unhelpful fine needle aspiration cytology examination, an assumption of metastatic neck disease could have been made. Subsequent surgical and/or oncological intervention would have been highly inappropriate, with potentially catastrophic effects. This case highlights the importance of proper diagnosis, and emphasises the fact that tuberculosis should always be borne in mind in the differential diagnosis.

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Reactivation of Pulmonary Tuberculosis in Malignancy

Cited by 40 publications

References 15 publications

Risk of tuberculosis in patients with solid cancers and haematological malignancies: a systematic review and meta-analysis

Risk of tuberculosis in patients with solid cancers and haematological malignancies: a systematic review and meta-analysis

Is Tuberculosis a Challenge in the Management of Lung Cancer?

Tuberculous cervical lymphadenitis in a patient with laryngeal carcinoma

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