Results of diagnostic dilemma between lung cancer and sputum negative pulmonary tuberculosis: a retrospective study

Diagnostic dilemma owing to radiological similarities between smear negative pulmonary tuberculosis and bronchogenic lung cancer pose a critical problem of late detection of the later with all its impact on the life of the victims.The aim of the study was to assess the magnitude and consequence of diagnostic dilemma between lung cancer and smear negative pulmonary tuberculosis. The retrospective observational study was conducted in the radiotherapy department of RG Kar Medical College and Hospital, Kolkata, West Bengal involving the lung cancer patients reported from February, 2009 to March, 2011. Out of the 76 lung cancer patients, 39.47% had exposure to anti tuberculosis treatment (ATT) before the actual diagnosis of lung cancer. Significantly higher proportion of rural patients was put on the ATT compared to their urban counterpart. Duration of symptoms before arrival was found significantly more among those who got ATT. Presence of any history of tuberculosis within the family was found to have significant association with the exposure to ATT before diagnosis as lung cancer. So in conclusion the treating physician must think twice before stamping a case as smear negative tuberculosis based on the radiological findings. High index of suspicion should also be maintained during treatment and follow-up of both smear positive and smear negative pulmonary tuberculosis as because the lung cancer may be preceded by or coexist with pulmonary tuberculosis.