Coexistence of tuberculosis and squamous cell carcinoma in the right main bronchus: A case report

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.

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.

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.