Carcinomatous pleuritis and pericarditis accompanied by pulmonary tuberculosis

Abstract

Although both lung cancer and pulmonary tuberculosis (TB) commonly occur in clinical practice, little attention has been paid to their coexistence. A 62-year-old female was admitted with acute dyspnoea secondary to cardiac tamponade. During her admission, a mass lesion harbouring air bronchograms in the right upper lobe rapidly increased in size. Surgical lung, pericardial, and pleural specimens yielded TB from a nodule in the right upper lobe and lung adenocarcinoma from the pericardium and pleura. Anti-tuberculous therapy was administered and gefitinib was subsequently started after the positive identification of epidermal growth factor receptor (EGFR) mutation (exon 19 deletion). The patient's general condition gradually improved with the anti-tuberculous and the EGFR-tyrosine kinase inhibitor (EGFR-TKI) treatment. Dual pathology is important to consider in patients with atypical radiological appearances. In those with proven EGFR mutation positive for lung cancer and pulmonary TB, sequential anti-tuberculous medication followed by EGFR-TKI treatment is advised.

Radiology and Ct Scan Findings in Patients With Simultaneous Occurrence of Tuberculosis and Lung Cancer

“…Regardless of all radiographic differences, lung cancer and tuberculosis cannot be differentiated with certainty [11]. However, the existence of a change in the form of new lesions, segmental or lobar atelectasis, unilateral hilar enlargement, thin-wall cavities, and localized pneumonia may suggest the simultaneous presence of tuberculosis and lung cancer [14]. Adequate treatment, in this case, involves simultaneous complex treatment of malignant and infectious diseases [13].…”