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KMID : 0857020050200010057
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Kosin Medical Journal
2005 Volume.20 No. 1 p.57 ~ p.62
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Active Pulmonary Tuberculosis in Patients with Lung Cancer
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Lee Jee-Hyun
Kim Nang-Hee
Jang Tae-Won
Kim Hee-Kyoo
Yang Sung-Woo
Kim Sun-Jung
Oak Chul-Ho
Jung Maan-Hong
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Abstract
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Background: This study aimed to reduce the delayed diagnosis of the coexisting active pulmonary tuberculosis in patients with lung cancer.
Methods: We analyzed clinical data of 30 cases (0.6%) among 4991 patients with coexisting lung cancer and active pulmonary tuberculosis encountered at Kosin University Gospel Hospital from January 1995 to July 2003.
Results: There were 23 men and 7 women, and eighty percent of patients were smokers. The histologic types of lung cancer were squamous cell carcinoma in 14, adenocarcinoma in 12, small cell carcinoma in 3, and large cell carcinoma in 1. The disease stages of lung cancer were stages Ⅱb in 1, Ⅲa in 4, Ⅲb in 11, Ⅳ in 11 in non-small cell lung cancer, limited stage in 1, and extensive stage in 2 in small cell lung cancer patients. The most common site of lesion was upper central part of the lung (50%). We classified the 30 cases into 2 groups as follows; The first group was active tuberculosis patients concurrently detected with lung cancer (Concurrent group, 17 cases), and the second group was tuberculosis sequential to lung cancer (Sequential group, 13 cases). Radiologic features in the concurrent group were nodular mass in 11, cavitary lesion in 3, consolidation in 2, and pleural effusion in 1. In contrast to this findings, in sequential group it showed consolidation in 8, cavitary lesion in 3, other findings in 1, and pleural effusion in 1. There was 27 days delayed at the diagnosis of pulmonary tuberculosis in the sequential group. The median survival time was 12 months in the concurrent group and 42 months in the sequential group. Treatment of pulmonary tuberculosis was 100% successful n the concurrent group and 62.5% successful in the sequential group.
Conclusion: This study indicated that physicians should consider the possibility of pulmonary tuberculosis in the cases with atypical chest x-ray presentation at the diagnosis of lung cancer, and during treatment of lung cancer also should suspect the coexistent active tuberculosis in such cases of pneumonia that does not respond to treatment.
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KEYWORD
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lung cancer, active pulmonary tuberculosis
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