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Chinese Journal of Antituberculosis ›› 2019, Vol. 41 ›› Issue (1): 64-68.doi: 10.3969/j.issn.1000-6621.2019.01.014

• Original Articles • Previous Articles     Next Articles

Analysis of the diagnosis and treatment of early lung cancer complicated with pulmonary tuberculosis manifested as ground-glass opacities

Da-wei LIU,Jian-kun ZHU,Feng JIN(),Cheng WANG,Yun-zeng ZHANG,Gao-feng QIAO,Bin ZHAO   

  1. Department of Thoracic Surgery,Shandong Provincial Chest Hospital Affiliated to Shandong University,Ji’nan 250013,China
  • Received:2018-10-16 Online:2019-01-10 Published:2019-01-09

Abstract:

Objective To analyze the clinical characteristics of early lung cancer complicated with pulmonary tuberculosis manifested as ground-glass opacity (GGO) in order to achieve the purpose of early identification and treatment.Methods We analyzed retrospectively the clinical manifestation, CT imaging features, operative method and pathological types in 14 cases of lung cancer complicated with pulmonary tuberculosis manifested with GGO diagnosed in Shandong Provincial Chest Hospital Affiliated to Shandong University during Jan. 2013 to Feb. 2018.Results Of 14 cases of early lung cancer complicated with pulmonary tuberculosis manifested with GGO, there were found by health examination in 9 cases, CT signs with obsolete tuberculous lesion manifested as mixed density GGO (mGGO) in 12 cases, GGO and tuberculous lesion located at the ipsilateral lung and same lobe in 4 cases. Nine patients were received standard chemotherapy before operation and 6 patients continued to chemotherapy after operation. Lung cancer was diagnosed by CT-guided puncture lung biopsy in 3 cases before operation, while the other 11 cases were confirmed by intraoperative frozen section pathological examination.Lung lobectomy and mediastinal lymph node dissection were performed in 10 cases, lobectomy (GGO location) plus local resection for tuberculoma located at ipsilateral lung different lobe in 2 cases, segmentectomy in 1 case, wedge resection in 1 case.Pulmonary tuberculosis was diagnosed by pathological examination in 10 cases, and by composite reference standard (CRS) based on medical history and CT imaging features in 4 cases. Samples from early lung cancer manifested GGO were diagnosed by pathological examination as adenocarcinoma in 11 cases, squamous cell carcinoma, adenosquamous squamous cell carcinoma and large cell carcinoma in each one cases. No metastasis was found by pathological examination in mediastinal lymph nodes. All the patients recovered well after operation. Norecurrence, metastasis of tumor and tuberculosis relapse occurred in the short term follow-up.Conclusion The clinical manifestations of early lung cancer patients complicated with pulmonary tuberculosis manifested by GGO are not specific. Thin-slice CT scanning and dynamic observation are helpful for diagnosis. Surgical method needs to give consideration to tumor resection and tuberculous foci management. It is satisfactory for efficacy that standard chemotherapy and surgical resection be performed in these patients,

Key words: Lung neoplasms, Tuberculosis, pulmonary, Comorbidity, Diagnostic imaging, Early diagnosis, Combined modality therapy, Evaluation studies