PURPOSE: Lung cancer can be masked by pulmonary tuberculosis, and the aim of this study is to clarify the clinical feature of lung cancer and pulmonary tuberculosis which coexist.
METHODS: We retrospectively analyzed 62 cases of coexistent lung cancer and pulmonary tuberculosis in St. Paul's Hospital, Uijeongbu St. Mary's Hospital and Dae-Jeon St. Mary's Hospital, the Catholic University of Korea between 1997 and 2008.
RESULTS: The subjects were 54 men and 8 women, with a mean age of 66 years. The most common symptom at admission were cough with sputum (55%) and 82.9% of patients had regular history of smoking with a mean 46 pack-year. Twenty-three cases (37%) were suspected clinically with pulmonary tuberculosis or pneumonia at admission, but not lung cancer. Thirty cases (50%) were suspected of pulmonary tuberculosis on initial radiography and there were no mass-like lesion which could be suspected of having lung cancer. Squamous cell carcinoma (46.7%) was the most common pathology type followed by small cell carcinoma (25%) and adenocarcinoma (21.7%). Lung cancers coexisting with pulmonary tuberculosis were located in the upper lobes (57.1%). In 30 cases (68%), two diseases coexisted in the same lobe. Diagnosis of lung cancer was made by bronchoscopic exam, in 33 cases (60%). In the view of stage, 60% of non-small cell cancer was in the stage III and IV, while 50% of small cell carcinoma was in the extensive stage.
CONCLUSION: Lung cancer and pulmonary tuberculosis often coexist and clinical feature of the two disease are very variable. Especially, when elderly man with the history of heavy smoking is admitted, physicians should try to search for coexisting two diseases.
CLINICAL IMPLICATIONS: Coexisting lung cancer and pulmonary tuberculosis is very important condition in Korea. When elderly man with the history of heavy smoking is suspected of pulmonary tuberculosis, physicians should not look over the possibility of coexisting lung cancer, although the radiographic findings are not clear, and should pay more intense attention to detect lung cancer in early stage.
DISCLOSURE: Hyeon Hui Kang, No Financial Disclosure Information; No Product/Research Disclosure Information