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. 2007 Feb 19:5:22.
doi: 10.1186/1477-7819-5-22.

Lung cancer in patients with tuberculosis

Saulius Cicenas  1 , Vladislavas Vencevicius
Affiliations

Lung cancer in patients with tuberculosis

Saulius Cicenas et al. World J Surg Oncol. .

Abstract

Background: Coexistent lung cancer and pulmonary tuberculosis is an urgent problem of thoracic surgery presenting a challenging task for diagnosis and surgical treatment.

Materials and methods: From 1990 to 2005, 2218 patients with lung cancer underwent surgical treatment in Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University. In 46 (2.1%) patients coexistence of lung cancer and tuberculosis was found. Central lung cancer was diagnosed in 37 (80.4%) and peripheral--in 9 (19.6%) patients. Epidermoid cancer was diagnosed in 24 (52.2%) patients, adenocarcinoma--in 10 (21.7%) and adenoepidermoid carcinoma--in 12 (26.1%) patients. Stage I cancer was diagnosed in 12 (26.1%), stage II--in 11 (23.9%), and stage IIIA--in 23 (50%) patients.

Results: Pneumonectomy was performed in 18 (39.2%), lobectomy in 10 (21.7%), bilobectomy in 10 (21.7%), segmentectomy in 8 (17.4%) patients. Postoperative surgical complications were observed in 9 (19.5%) patients, non-surgical complications occurred in 19 patients (41.3%). Six patients (13.04%) died. Combined treatment was applied to 23 (50%) patients.

Conclusion: Coexistence of tuberculosis and lung cancer in thoracic surgery is fairly rare. This combination was diagnosed only in 46 cases (2.1%) out of 2218 operated lung cancer patients. Epidermoid carcinoma and stage IIIA disease was diagnosed in 50% of patients. Postoperative surgical complications occurred in 9 patients (19.5%) with lung cancer and tuberculosis. Six patients (13%) died in postoperative period. Surgery is the method of choice in treatment of combination of tuberculosis and lung cancer. Median survival of these patients was 28 +/- 2 months.

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Figures

Figure 1
Figure 1
X-ray of the thorax. Infiltrative changes are observed in the left upper lobe.
Figure 2
Figure 2
Chest CT. There is pulmonary bulla in the right S1 segment, and focus of mottled opacity 7,5 × 2,5 cm with infiltration around it.
Figure 3
Figure 3
Postoperative specimen. Tumor occludes lumen of bronchus (1) and tuberculosis(2).
Figure 4
Figure 4
Microview of resected specimen H&E stain, ×20. Tumor cells (1) and tuberculosis changes (2) are seen.
See this image and copyright information in PMC

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