Tuberculosis and Carcinoma of the Lung

¹ The Veterans' Administration Hospital, Butler, Pennsylvania.

1) Three cases are reported of co-existing tuberculosis and carcinoma of the lung. All cases were diagnosed during life; all cases were diagnosed too late for surgery.

2) The diagnosis of carcinoma in the presence of pulmonary tuberculosis depends on the same studies as in the absence of tuberculosis—x-ray, bronchoscopy, cell-block of sputum and pleural fluid, biopsy of suspected metastatic nodes, and exploratory thoractomy. The history is of diminished value, because the symptoms may be caused by tuberculosis as well as by carcinoma.

3) Carcinoma should be suspected when symptoms are out of proportion to the size of the tuberculous lesion, when there is unexplained dyspnoea or pain, or when x-ray shows an area of atelectasis. The diagnosis of carcinoma in the presence of pulmonary tuberculosis is usually made too late because it is not suspected.