Pulmonary tuberculosis as differential diagnosis of lung cancer

MLB Bhatt; Surya Kant; Ravi Bhaskar

doi:10.4103/2278-330X.96507

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Diagnostic Dilemma

01 (

); 36-42

doi:

10.4103/2278-330X.96507

Pulmonary tuberculosis as differential diagnosis of lung cancer

MLB Bhatt^1,, Surya Kant², Ravi Bhaskar²

1 Departments of Radiotherapy, C.S.M. Medical University, Lucknow, Uttar Pradesh, India

2 Departments of Pulmonary Medicine, C.S.M. Medical University, Lucknow, Uttar Pradesh, India

*Corresponding author: Dr. MLB Bhatt. drmlbhatt@yahoo.com

Published: 2020-11-09

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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Abstract

Patients with lung cancer are often misdiagnosed as pulmonary tuberculosis leading to delay in the correct diagnosis as well as exposure to inappropriate medication. Several factors are responsible for this situation in developing countries, including lack of awareness, inadequate infrastructure and socio-economic factors. This article outlines the differences between the two diseases as well as features that would make a clinician suspect the right diagnosis early.

Keywords

References

World health organization. Global tuberculosis control; 2011.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer, 2010. Available from: http://globocan.iarc.fr. [Last Accessed 2011 May].
GLOBOCAN 2002, 2008 database, International Agency for Research on Cancer, World Health Organization. Available from: http://globocan.iarc.fr/. [Last Accessed 2011 May].
Parkin DM, Muir CS. Cancer incidence in five continents: Comparability and quality of data. IARC Sci Publ 1992;120:45-173.
Pesut DP, Marinkovic DM. Lung cancer and pulmonary tuberculosis-A comparative population-genetic study. British J. Med. Genetics, 2009;12:45-52.
Behera D, Balamugesh T. Lung cancer in India. Indian J Chest Dis Allied Sci 2004;46:269-81.
Notani P, Sanghavi LD. A retrospective study of lung cancer in Bombay. Br J Cancer 1974;29:477-82.
Mohan A, Sharma SK. Fibreoptic bronchoscopy in the diagnosis of sputum smear-negative pulmonary tuberculosis: Current status. Indian J Chest Dis Allied Sci 2008;50:67-78.
Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R. A common medical error: Lung cancer misdiagnosed as sputum negative tuberculosis. Asian Pac J Cancer Prev 2009;10:335-8.
Wig KL, Lazaro EJ, Gadekar NG, Guleria JS. Bronchogenic carcinoma: Clinical features and diagnosis. Indian J Chest Dis 1961;3:209-18.
Gurney JW. Determining the likelihood of malignancy in solitary pulmonary nodules with Bayesian analysis. Radiology 1993;186:405-13.
Higgins GA, Shields TW, Keehn RI. The solitary pulmonary nodule. Arch Surg 1975;110:570-5.
Sider L. Radiographic manifestations of primary bronchogenic carcinoma. Radiol Clin North Am 1990;28:583-97.
Theros EG. Varying manifestations of peripheral pulmonary neoplasms. A radiologic-pathologic correlative study. Am J Roentgenol 1977;128:893-914.
Siegelman SS, Zerhouni EA, Leo FP, Khouri NF, Stitik FP. CT of the solitary pulmonary nodule. Am J Roentgenol 1980;135:l-13.
Oswald NC, Hinson KF, Canti G, Miller AB. The diagnosis of primary lung cancer with special reference to sputum cytology. Thorax 1971;26:623.
Khajotia RR, Mohn A, Vetter N, Pokieser L, Schalleschak J. Induced sputum and cytological diagnosis of lung cancer. Lancet 1991;338:976-7.
Jalleh RD, Kuppusamy I, Parameswary V, Yeow CS. Fibreoptic bronchoscopy in the diagnosis of pulmonary tuberculosis - A Malaysian experience. Singapore Med J 1993;34:55-7.
Tapia Acuna R. Bronchoscopy in pulmonary tuberculosis. Dis Chest 1945;11:392-7.
Fergusson RJ. Lung Cancer. In: Crofton and Douglas′s Respiratory Diseases. 5 th ed. New Delhi: Wiley India (P) Ltd.; 2008. p. 1077-122.
Bhatia R. Laboratory Diagnosis. In: Sharma SK, editor. Tuberculosis. 2nd ed. New Delhi: JAYPEE Brothers Medical Publishers (P) Ltd.; 2009. p. 168.
Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R. A common medical error: Lung cancer misdiagnosed as sputum negative tuberculosis. Asian Pac J Cancer Prev 2009;10:335-8.
Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111:1710-7.
Burrill J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR. Tuberculosis: A radiologic review. RadioGraphics 2007;27:1255-73.
Alberts WM. Diagnosis and management of lung cancer: ACCP guidelines. Chest 2007;132:1S-19.
Williams WR, Thompson JR. Differential diagnosis of Pulmonary Tuberculosis and Lung Cancer - Are cytologic studies of blood and bone marrow of value? Chest 1965;47:70-6.
Khuri FR, Herbst RS, Fossella FV. Emerging therapies in non-small cell lung cancer. Ann Oncol 2001;12:739-44.
Sharma CP, Behera D, Aggarwal AN, Gupta D, Jindal SK. Radiographic patterns in lung cancer. Indian J Chest Dis Allied Sci 2002;44:25-30.
Wu AH, Fontham ET, Reynolds P, Greenberg RS, Butfler P, Liff J, et al. Previous lung diseases and risk of lung cancer among lifetime non smoking women in the United States. Am J Epidemiol 1995;141:1023-32.
Cicenas S, Vencevicius V. Lung cancer in patients with tuberculosis. World J Surg Oncol 2007;5:22.
Danek SJ, Bower JS. Diagnosis of pulmonary tuberculosis by flexible fiberoptic bronchoscopy. Am Rev Respir Dis 1979;119:677-9.
Feng TC. Analysis of 27 patients with lung cancer misdiagnosed as tuberculosis. Zhonghua Zhong Liu Za Zhi 1989;11:458-60.
Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: A meta-analysis. JAMA 2001;285:914-24.
Kant S, Saheer S, Prakash V, Hasan G, Jabeed P, Husain N. Bilateral nodular pulmonary tuberculomas simulating metastatic disease. BMJ Case Rep 2011;11:35-9.
Kant S, Kushwaha RA, Verma SK, Sanjay. Bilateral nodular pulmonary tuberculosis simulating metastatic lung cancer. Internet J Pulm Med 2007;8:1531.
Kant S, Garg R, Tripathi AK. Approach to a solitary pulmonary nodule. J of Internal Medicine of India 2000;3:131-6.
D. Tuberculosis. In: Behera D, editor. Textbook of Pulmonary Medicine. 2nd ed. New Delhi: JAYPEE Brothers Medical Publishers (P) Ltd.; 2010. p. 521-2.

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[1] World health organization. Global tuberculosis control; 2011.

[2] Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer, 2010. Available from: http://globocan.iarc.fr. [Last Accessed 2011 May].

[3] GLOBOCAN 2002, 2008 database, International Agency for Research on Cancer, World Health Organization. Available from: http://globocan.iarc.fr/. [Last Accessed 2011 May].

[4] Parkin DM, Muir CS. Cancer incidence in five continents: Comparability and quality of data. IARC Sci Publ 1992;120:45-173.

[5] Pesut DP, Marinkovic DM. Lung cancer and pulmonary tuberculosis-A comparative population-genetic study. British J. Med. Genetics, 2009;12:45-52.

[6] Behera D, Balamugesh T. Lung cancer in India. Indian J Chest Dis Allied Sci 2004;46:269-81.

[7] Notani P, Sanghavi LD. A retrospective study of lung cancer in Bombay. Br J Cancer 1974;29:477-82.

[8] Mohan A, Sharma SK. Fibreoptic bronchoscopy in the diagnosis of sputum smear-negative pulmonary tuberculosis: Current status. Indian J Chest Dis Allied Sci 2008;50:67-78.

[9] Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R. A common medical error: Lung cancer misdiagnosed as sputum negative tuberculosis. Asian Pac J Cancer Prev 2009;10:335-8.

[10] Wig KL, Lazaro EJ, Gadekar NG, Guleria JS. Bronchogenic carcinoma: Clinical features and diagnosis. Indian J Chest Dis 1961;3:209-18.

[11] Gurney JW. Determining the likelihood of malignancy in solitary pulmonary nodules with Bayesian analysis. Radiology 1993;186:405-13.

[12] Higgins GA, Shields TW, Keehn RI. The solitary pulmonary nodule. Arch Surg 1975;110:570-5.

[13] Sider L. Radiographic manifestations of primary bronchogenic carcinoma. Radiol Clin North Am 1990;28:583-97.

[14] Theros EG. Varying manifestations of peripheral pulmonary neoplasms. A radiologic-pathologic correlative study. Am J Roentgenol 1977;128:893-914.

[15] Siegelman SS, Zerhouni EA, Leo FP, Khouri NF, Stitik FP. CT of the solitary pulmonary nodule. Am J Roentgenol 1980;135:l-13.

[16] Oswald NC, Hinson KF, Canti G, Miller AB. The diagnosis of primary lung cancer with special reference to sputum cytology. Thorax 1971;26:623.

[17] Khajotia RR, Mohn A, Vetter N, Pokieser L, Schalleschak J. Induced sputum and cytological diagnosis of lung cancer. Lancet 1991;338:976-7.

[18] Jalleh RD, Kuppusamy I, Parameswary V, Yeow CS. Fibreoptic bronchoscopy in the diagnosis of pulmonary tuberculosis - A Malaysian experience. Singapore Med J 1993;34:55-7.

[19] Tapia Acuna R. Bronchoscopy in pulmonary tuberculosis. Dis Chest 1945;11:392-7.

[20] Fergusson RJ. Lung Cancer. In: Crofton and Douglas′s Respiratory Diseases. 5 th ed. New Delhi: Wiley India (P) Ltd.; 2008. p. 1077-122.

[21] Bhatia R. Laboratory Diagnosis. In: Sharma SK, editor. Tuberculosis. 2nd ed. New Delhi: JAYPEE Brothers Medical Publishers (P) Ltd.; 2009. p. 168.

[22] Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R. A common medical error: Lung cancer misdiagnosed as sputum negative tuberculosis. Asian Pac J Cancer Prev 2009;10:335-8.

[23] Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111:1710-7.

[24] Burrill J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR. Tuberculosis: A radiologic review. RadioGraphics 2007;27:1255-73.

[25] Alberts WM. Diagnosis and management of lung cancer: ACCP guidelines. Chest 2007;132:1S-19.

[26] Williams WR, Thompson JR. Differential diagnosis of Pulmonary Tuberculosis and Lung Cancer - Are cytologic studies of blood and bone marrow of value? Chest 1965;47:70-6.

[27] Khuri FR, Herbst RS, Fossella FV. Emerging therapies in non-small cell lung cancer. Ann Oncol 2001;12:739-44.

[28] Sharma CP, Behera D, Aggarwal AN, Gupta D, Jindal SK. Radiographic patterns in lung cancer. Indian J Chest Dis Allied Sci 2002;44:25-30.

[29] Wu AH, Fontham ET, Reynolds P, Greenberg RS, Butfler P, Liff J, et al. Previous lung diseases and risk of lung cancer among lifetime non smoking women in the United States. Am J Epidemiol 1995;141:1023-32.

[30] Cicenas S, Vencevicius V. Lung cancer in patients with tuberculosis. World J Surg Oncol 2007;5:22.

[31] Danek SJ, Bower JS. Diagnosis of pulmonary tuberculosis by flexible fiberoptic bronchoscopy. Am Rev Respir Dis 1979;119:677-9.

[32] Feng TC. Analysis of 27 patients with lung cancer misdiagnosed as tuberculosis. Zhonghua Zhong Liu Za Zhi 1989;11:458-60.

[33] Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: A meta-analysis. JAMA 2001;285:914-24.

[34] Kant S, Saheer S, Prakash V, Hasan G, Jabeed P, Husain N. Bilateral nodular pulmonary tuberculomas simulating metastatic disease. BMJ Case Rep 2011;11:35-9.

[35] Kant S, Kushwaha RA, Verma SK, Sanjay. Bilateral nodular pulmonary tuberculosis simulating metastatic lung cancer. Internet J Pulm Med 2007;8:1531.

[36] Kant S, Garg R, Tripathi AK. Approach to a solitary pulmonary nodule. J of Internal Medicine of India 2000;3:131-6.

[37] D. Tuberculosis. In: Behera D, editor. Textbook of Pulmonary Medicine. 2nd ed. New Delhi: JAYPEE Brothers Medical Publishers (P) Ltd.; 2010. p. 521-2.

Pulmonary tuberculosis as differential diagnosis of lung cancer

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