[Pulmonary tuberculosis in patients with hematological malignancies]

Abstract

Introduction: Lung tuberculosis, resulting from decreased cellular immunity, is associated with malignancies and is most frequently seen in Hodgkin's disease, leukemia and T-cell lymphoma.

Material and methods: In the period 1995-2000, 20 patients (pts) with lung tuberculosis and hematological malignancies were analyzed, out of whom 7 (35%) were females, with mean age of 56 years, and 13 (65%) were males, with mean age of 55 years.

Results and discussion: Among the affected, 8 (40%) patients had Non-Hodgkin's lymphoma, 5 (25%) suffered from chronic lymphocytic leukemia, 4 (2%) had Hodgkin's disease, 1 (5%) manifested a myelodysplastic syndrome, 1 (5%) multiple myeloma and 1 (5%) had chronic myeloid leukemia. The average time from completing a specific cancer therapy and development of tuberculous infection was 20 months, except in 3 cases who had a hematological malignancy and lung tuberculosis at the time of initial diagnosis. The diagnosis was made on the basis of positive findings of sputum smear in 15 (75%) pts, by bronchological examination and sputum analysis in 3 (15%) pts, lymph node biopsy and sputum analysis in 1 (5%) case, pleural biopsy in 1 (5%) patient, and finally confirmed by culture in 19 (95%) pts. Radiological examination revealed fibrocaseous tuberculosis in 14 (70%) pts, out of whom 12 with bilateral and 2 with unilateral changes, 3 (15%) manifested miliary tuberculosis, and 3 (15%) had pleural effusion and tuberculosis.

Conclusion: Successful outcome was achieved in 18 (90%) pts, while lethal outcome was reported in 2 (10%) cases with miliary pulmonary tuberculosis.