Unusual occurrence of two pathologies in one lung - pulmonary tuberculosis and primary lung carcinoma

Abstract

Tuberculosis and lung cancer rarely coincide together but have been proven to have a definitive link and that cause substantial morbidity and mortality worldwide. We present the case report of 58yr old male presented with left sided abdominal pain and breathlessness for past 2 months, h/o ATT taken for 4 months from February 2016 for sputum positive TB and stopped due to abdominal pain. He is chronic smoker. Respiratory system examination showed decreased breath sounds, VF, VR in left infrascapular, infraaxillary area .P/A examination - tenderness in the left hypochondrial region. Serial CXR‘s from February showed infiltrates in the upper zones which became stable lesions later with  increasing left sided non homogenous opacity in the mid and lower zones. Sputum AFB– Negative. CECT Chest and Abdomen showed large mass in left lower lobe with adrenal and nodal metastasis. Bronchoscopy showed fungating mass in the left main bronchus. HPE of biopsy showed  moderately differentiated squamous cell carcinoma. This case is being presented to create awareness among the clinicians of simultaneous occurrence of two different entities in a single person and proper screening for malignancy in all patients with radiological worsening even after ATT.