Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2021; 9(25): 7520-7526
Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7520
Coexistence of tuberculosis and squamous cell carcinoma in the right main bronchus: A case report
Hui Jiang, Ya-Qing Li
Hui Jiang, Department of Internal Medicine, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Ya-Qing Li, Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou 310014, Zhejiang Province, China
Author contributions: Li YQ and Jiang H contributed equally to this work; Li YQ and Jiang H designed the research study, performed the research, contributed new reagents and analytic tools, analyzed the data, and wrote the manuscript; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 8187010048.
Informed consent statement: Written informed consent was obtained from the patient for the publication of the case details and images.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Qing Li, PhD, Chief Doctor, Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 158 Shangtang Road, Xiacheng District, Hangzhou 310014, Zhejiang Province, China. jiangdoctor1988@126.com
Received: February 15, 2021
Peer-review started: February 15, 2021
First decision: March 11, 2021
Revised: March 29, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: September 6, 2021
Processing time: 197 Days and 5.2 Hours
Abstract
BACKGROUND

Lung cancer with pulmonary tuberculosis (TB) refers to the occurrence of lesions simultaneously or sequentially in the lung(s) of the same patient, and the pathological examination and sputum TB examination diagnose them as lung cancer and TB, respectively. The occurrence of endobronchial TB (EBTB) with endobronchial tumor sequentially in the same bronchus lesion of the same patient is relatively rare.

CASE SUMMARY

A 62-year-old female patient was admitted to a local hospital on June 18, 2019 after a 3-mo history of dyspnea. She was a farmer and had no history of smoking and alcohol misuse. The patient had neither family nor work contact indicating exposure to TB. Emergency chest computed tomography (CT) examination showed that the right main bronchus was occupied and malignant tumor was possible. Histopathologic examination of a bronchial biopsy showed granulomatous inflammation with caseification and the presence of acid fast bacilli (AFB). However, after 6 mo of antitubercular treatment, repeat bronchoscopy and biopsy histological examination showed squamous cell carcinoma. The patient has started on systemic chemotherapy with carboplatin. After another two cycles of therapy, chest CT showed complete resolution of the lesions. Bronchoalveolar lavage and bronchial aspirate were negative for AFB and cancer cells.

CONCLUSION

It is not only more likely that a patient presenting with what appears to be TB will concurrently have a pulmonary malignancy than someone who does not have a TB infection, but also that it is of greater urgency to make an expedited diagnosis of the malignancy.

Keywords: Tumorous endobronchial tuberculosis; Bronchial squamous cell cancer; Diagnosis; Treatment; Case report

Core Tip: In the correct clinical setting, lesions such as those seen during bronchoscopy should alert the physician to the possibility of active tuberculosis (TB). With the advancement of diagnostic techniques, the screening of high-risk populations of patients with lung cancer, and the prolongation of postoperative survival rates, and the close follow-up of lung cancer patients with TB, it is expected that TB can be detected in an early stage with a good prognosis after treatment.