Source: Annual Congress 2003 - Clinical features in tuberculosis - I
Disease area: Respiratory infections, Thoracic oncology

Abstract

The tuberculosis is in the first place among infectious diseases according to the mortality rate. Even in the developed countries where it was kept under control it is reemerging. In Croatia the incidence of tuberculosis is higher than in Western Europe (34/100000 in 2001) and slowly declining.
We analyzed the incidence of tuberculosis among the lung cancer (LC) patients treated in our hospital and expectedly it was considerably higher than in general population. This high incidence can be attributed to the immunosuppressive effect of the tumor per se but also of the cancer therapy. In accordance with this, one of our patients presented with coexisting LC and tuberculosis while the others developed tuberculosis during chemotherapy or with the progression of the disease. We single out the patient with NSCLC who was under the chemotherapy regimen when he presented with the worsening of clinical symptoms. A pericardial effusion was discovered, attributed at first to the progression of LC. A pericardial drainage was performed and no malignant elements, but a high count of lymphocytes was detected in the fluid. Acid fast bacilli (AFB) were visible in the direct smear, being a rare case, and confirmed by a positive culture. AFB were detected in sputum smear as well and the standard therapy for tuberculosis was started.
Analyzing this particular case and some of the other cases of tuberculosis in LC patients it is evident that tuberculosis is a great impostor, making it sometimes hard to distinguish between the progression of the LC itself and the development of tuberculosis. This needs to be kept in mind for a better outcome for our patients.

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Citations should be made in the following way:
M. Roglic, S. Popovic-Grle, L. Pavlovic, F. Pavicic (Zagreb, Croatia). Tuberculosis' mimicry in lung cancer patients. Eur Respir J 2003; 22: Suppl. 45, 991

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