American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2014, 2(8), 164-166
DOI: 10.12691/ajmcr-2-8-6
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Cavitary Lung Disease: Not Always due to Tuberculosis! Primary Lung Cancer with Smear Positive Pulmonary Tuberculosis- A Case Report

Shital Patil1, and Halkanche Gajanan1

1Department of Medicine, MIMSR Medical college, Latur, India

Pub. Date: September 02, 2014

Cite this paper:
Shital Patil and Halkanche Gajanan. Cavitary Lung Disease: Not Always due to Tuberculosis! Primary Lung Cancer with Smear Positive Pulmonary Tuberculosis- A Case Report. American Journal of Medical Case Reports. 2014; 2(8):164-166. doi: 10.12691/ajmcr-2-8-6


Pulmonary Tuberculosis is the leading cause of cavitary lung disease globally. Although clinical scenario of majority of the disorders causing cavitation and hemoptysis are overlapping, special emphasis should be given on smoking history and concomitant clubbing especially in elderly population. CT thorax will differentiate probability of malignancy as cause of cavity by delineating its pericavitary nodularity, irregular wall, thickness and size. Bronchoscopy is must in all the cases, will help to confirm the diagnosis and ruling out underlying malignancy. Squamous cell carcinoma is known to cause cavitation and the only histological lung cancer type causing such radiological abnormality. In this case report we described a elderly male patient presented with persistent intermittent hemoptysis with chest pain and clubbing on clinical evaluation. Initially diagnosed as a case of smear positive pulmonary tuberculosis finally we confirmed as Primary Lung cancer of Squamous cell origin. High index of suspicion is must in such cases, with bronchoscopy and cytopathology expertise in lung histopathology will be crucial in confirming diagnosis.

cavitary lung disease tuberculosis bronchoscopy squamous cell carcinoma

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[1]  Pandey M, Abraham E, Chandramohan K, Rajan B. Tuberculosis and metastatic carcinoma coexistence in axillary lymph node: A case report. World J Surg Oncol 2003; 1: 3.
[2]  Bayle GI. Recherches sur la phthisie pulmonaire. Paris, Gabon, 1810.
[3]  Schottenfeld D, Beebe-Dimmer J. Chronic inflammation: a common and important factor in the pathogenesis of neoplasia.CA Cancer J Clin 2006; 56: 69-83.
[4]  McSherry D. Avoiding premature closure in sequential diagnosis. Artif Intell Med 1997; 10: 269-83.
[5]  M.E. Falagas, V.D. Kouranos, Z. Athanassa and P. Kopterides. Tuberculosis and malignancy: Q J Med 2010; 103: 461-487.
[6]  Mogga SJ, Mustafa T, Sviland L, Nilsen R. Increased Bcl-2 and reduced Bax expression in infected macrophages in slowly progressive primary murine Mycobacterium tuberculosis infection. Scand J Immunol 2002; 56: 383-91.
[7]  Sharma S, Sharma M, Roy S, Kumar P, Bose M. Mycobacterium tuberculosis induces high production of nitric oxide in coordination with production of tumour necrosis factor-alpha in patients with fresh active tuberculosis but not in MDR tuberculosis. Immunol Cell Biol 2004; 82: 377-82.
[8]  Lin HH, Ezzati M, Murray M. Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and metaanalysis. PLoS Med 2007; 4: e20.
[9]  Houtmeyers E, Gosselink R, Gayan-Ramirez G, Decramer M. Regulation of mucociliary clearance in health and disease. Eur Respir J 1999; 13: 1177-88.
[10]  Sakuraba M, Hirama M, Hebisawa A, Sagara Y, Tamura A, Komatsu H. Coexistent lung carcinoma and active pulmonary tuberculosis in the same lobe. Ann Thorac Cardiovasc Surg 2006; 12: 53-5.
[11]  Yoon Y, Curry K. Concurrence of granular cell tumor and Mycobacterium tuberculosis. South Med J 2005; 98: 1034-5.
[12]  Kim YI, Goo JM, Kim HY, Song JW, Im JG. Coexisting bronchogenic carcinoma and pulmonary tuberculosis in the same lobe: radiologic findings and clinical significance. Korean J Radiol 2001; 2: 138-44.
[13]  Zheng W, Blot WJ, Liao ML, Wang ZX, Levin LI, Zhao JJ, et al. Lung cancer and prior tuberculosis infection in Shanghai. Br J Cancer 1987; 56: 501-4.
[14]  Cicenas S, Vencevicius V. Lung cancer in patients with tuberculosis. World J Surg Oncol 2007; 5: 22.