The first report of co-existence of pulmonary tuberculosis and lung malignancy in a kidney transplant recipient: a case report and literature review

Abstract

Background Along with the medical development, organ transplant patients increase dramatically. Since these transplant patients take immunosuppressants for a long term, their immune functions are in a suppressed state, prone to all kinds of opportunistic infections and cancer. However, it is rarely reported that the kidney transplant recipients (KTRs) have pulmonary tuberculosis and lung cancer simultaneously. Case presentation A 60-year-old male was admitted because of persistent lung shadow for 2 years without any obvious symptom 8 years after renal transplant. T-SPOT test was positive but other etiological examinations for Mycobacterium tuberculosis were negative. Chest CT scan revealed two pulmonary lesions in the right upper and lower lobe respectively. 18F-fluorodesoxyglucose positron-emission tomography (FDG-PET) CT found FDG intake increased in both pulmonary consolidation lesions. CT-guided percutaneous transthoracic needle biopsy revealed lung adenocarcinoma and tuberculosis. The video-assisted thoracoscopic surgery was operated to resect the malignancy lesions. The patient received specific anti-tuberculosis therapy and was discharged. At the follow-up of 6 months post drug withdrawal, the patient was recovered very well. Conclusions We for the first time reported co-existence of smear-negative pulmonary TB and lung adenocarcinoma in a KTR, which highlighted the clinical awareness of co-occurrence of TB and malignancy after renal transplant and emphasized the value of biopsy and 18F-FDG-PET in early diagnosis of TB and cancer.

Gefitinib effectively treated advanced lung cancer with a rare EGFR L747P mutation in a kidney transplant recipient: the first case report

“…Lung cancer is one of the leading causes of cancer mortality in KTRs, yet the cure rate for early, operable lung cancer is very high. Therefore, it is very necessary to annual screen for people at high risk of lung cancer using low-dose CT. Further, pulmonary nodules screened by chest CT should be distinguished from pulmonary tuberculosis, pulmonary mycosis, lung cancer, etc., and special attention should be paid to the situation of infection combined with malignant tumor 18,19 .…”

Chemoprophylaxis for the prevention of tuberculosis in kidney transplant recipients: A systematic review and meta-analysis

“…Kidney transplantation (KT) is the most important replacement therapy for patients with end-stage kidney disease (ESKD) ( Lamb et al, 2011 ); it can improve the prognosis and life quality of ESKD patients ( Park et al, 2020 ). With the wide use of immunosuppressive drugs, the survival rates of patients and grafts have improved remarkably ( Singh et al, 2016 ; Hosohata et al, 2018 ), while opportunistic infections caused by excessive immunosuppression have also increased ( Fang et al, 2021 ).…”

Tuberculosis combined with Burkitt lymphoma in a kidney transplant recipient: A case report and literature review

“…With a global co-prevalence of 2.51% and considerably higher in underdeveloped nations, tuberculosis (TB) is the most prevalent infectious complication following kidney transplantation and is thought to be a significant issue influencing the long-term survival of kidney transplant Hu et al • Medicine (2023) 102: 18 Medicine recipients (KTRs). [1] In addition to TB, post-transplant lymphoproliferative disorders (PTLDs) are the second most common malignancy in adult KTRs. [2] Among PTLDs, adult Burkitt lymphoma (BL) is rarely reported in solid organ transplant (SOT) patients.…”