RT Journal Article
SR Electronic
T1 Coexistence of intrathoracic lymphoma and pulmonary tuberculosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4452
VO 42
IS Suppl 57
A1 Yi-Hsuan Tsai
A1 Tzu-Yu Kuo
A1 Kuan-Li Wu
A1 Chia-Min Chen
A1 Yu-Chieh Chung
A1 Ming-Shyan Huang
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4452.abstract
AB It has been suggested that risk of lymphoma is increased after tuberculosis (TB). However, coexistence of lymphoma and TB in the same organ is quite rare and may result in delayed diagnosis and treatment dilemma. Herein, we reported two cases of coexistence of lymphoma and TB.Case A: A 73-year-old woman presented with intermittent dyspnea, productive cough and mild fever for weeks. The chest CT revealed left lower lung tumor with extension to the hilum, causing partial atelectasis of left upper lung (LUL). Bronchoscopic biopsy revealed diffuse large B cell lymphoma (DLBCL) and bronchioalveolar lavage (BAL) was positive for acid-fast stain (AFS) and TB-PCR. After anti-TB treatment and chemotherapy, the mass shrank and atelectasis of LUL resolved.Case B: An 88-year-old woman presented with a neck mass, dyspnea, dysphagia, mild fever and night sweating for 7 months. CT revealed mass lesion involving left lung and cervical lymph nodes with compression of trachea. Her sputum was positive for AFS and TB-PCR. Biopsy revealed DLBCL. She was intubated for respiratory failure. Despite of aggressive chemotherapy and anti-TB treatment, her disease progressed rapidly and she expired 3 months later.Being an uncommon circumstance, coexistence of pulmonary tuberculosis and lymphoma involving the lung increases the difficulty in diagnosis and treatment. In area with high TB prevalence, screening respiratory specimens for TB is suggested for patients with pulmonary lesions. Chemotherapy for lymphoma may induce progression of TB, whereas treating TB first may delay the treatment for lymphoma. Therefore, aggressive concomitant treatment with anti-TB drugs and chemotherapy is suggested for patients with coexisting disease.