Two case of concomitant tuberculosis and lung cancer diagnosed by bronchoscopy

L. Wang*^a (Dr), J. Xia^a (Dr), J. Ye^a (Dr), L. Wang^a (Dr)

^a Department of Pulmonary Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, CHINA

* wangliusheng0201@126.com

Purpose:

To explore the diagnostic value of bronchoscopy in pulmonary tuberculosis complicated with lung cancer, as well as the clinical features and treatment progress of pulmonary tuberculosis complicated with lung cancer.

Method:

In the past 1 year, 2 patients with pulmonary tuberculosis complicated with lung cancer diagnosed by bronchoscopy in our department were collected.

result:

Both patients were previously diagnosed with pulmonary tuberculosis and had received regular anti-tuberculosis treatment. CT scan of the chest showed typical imaging findings of tuberculosis. All patients presented with cough without hemoptysis, chest pain, night sweats and fever. Sputum was negative for Mycobacterium tuberculosis. The tumor markers in case 1 were NSE 25.76 μg/L and CYFRA21-1 4.95 μg/L; in case 2 the tests were normal. Complete bronchoscopy biopsy, all diagnosed as lung cancer, staging examination confirmed all advanced lung cancer. The bronchoalveolar lavage fluid of case 1 was positive for Xpert. BALF of case 2 was positive for Mycobacterium tuberculosis by qPCR.

Conclusion:

Both pulmonary tuberculosis and lung cancer are common diseases of the respiratory system, and patients with pulmonary tuberculosis have a higher risk of developing lung cancer. The clinical manifestations and imaging of the two diseases are similar, which leads to missed diagnosis of lung cancer. Bronchoscopy can reduce the possibility of missed diagnosis and identify the coexistence of the two diseases, which is conducive to treatment and improved prognosis.

Disclosure of funding source(s): none