Why are TB patients prone to lung cancer? The analysis of the general environment may be related to the improvement of medical conditions in urban and rural areas, the availability of strong anti-tuberculosis drugs for all TB patients, the significant reduction of mortality rate of TB patients, and the tendency of TB patients to be older. Also, factors such as environmental pollution, smoking, and reduced body immune function have increased the chance of developing lung cancer.
Clinical studies have also identified the following possibilities.
1. it is the obstruction of lymphatic return by tuberculous scar tissue, which is likely to cause accumulation of carcinogens and induce cancer.
2. it is the chronic stimulation of the tuberculosis lesion that prompts abnormal proliferation of epithelial cells in the lesion and adjacent tissues.
3. it is the dilatation of bronchial tubes around the tuberculosis lesion and poor drainage that facilitate the retention of carcinogens in the respiratory tract
4. it is the cancer that can reduce the immune function of the body, which increases the chance of simultaneous occurrence of tuberculosis and lung cancer.
The clinical symptoms and X-ray manifestations of lung cancer and tuberculosis are often confused, especially with those patients with strong positive tuberculin test and positive sputum smear for antacid bacilli, which are sometimes more difficult to distinguish. However, even the most cunning “fox” will reveal its tail. The following ten points are the evidence to detect the coexistence of lung cancer and tuberculosis.
1. Middle-aged and old-aged patients with tuberculosis, who have been treated with systematic anti-tuberculosis therapy and then suddenly develop cough, blood in sputum or small blood clots.
2.Except for diabetes mellitus or the original diabetes mellitus has been treated and the blood sugar and urine sugar have been controlled in the normal range but symptoms such as rapid weight loss, emaciation and anemia appear.
3.Irregular fever, continuous fixed position of chest pain or dull pain.
4.Patients with tuberculosis develop hoarseness.
5, Painless enlarged lymph nodes on the clavicle are palpated.
6.Tuberculosis lesions increase in size during the course of anti-tuberculosis treatment.
7.The lesion is in the good part of tuberculosis, but the anti-tuberculosis treatment is ineffective.
8.Patients with pulmonary tuberculosis develop hemorrhagic pleural effusion during treatment.
9, chest X-ray found difficult to explain the signs of pulmonary atelectasis.
10.Signs such as bone and joint enlargement and drumstick finger (pestle finger) are found during treatment in patients with pulmonary tuberculosis.
Hemothorax and hemoptysis: may occur in a few cases, but massive bleeding is rare.
Thoracic infection: mostly seen in those with severe infection of the original respiratory tract and lung, and it is safer to perform after effective antibiotic treatment.
Needle tract implantation of cancer cells . It can be effectively avoided with trocar needle technique.