癌の治療による結核の悪化, 特に癌の肺転移との鑑別

概要

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Two cases of tuberculosis exacerbation, both with calcified foci on the chest roentgenogram, in duced during treatment for different cancer are presented. One is a miliary tuberculosis affecting a 65-year-old female with relapsed breast cancer who had received adjuvant chemotherapy containing 5mg-a-day predonin for 28 days after radical mastectomy. The other case is a fibroproductive tuber culosis with cavity beneath the radiation fibrosis at the apex found in a 69-year-old male who had received left radical tonsillectomy with radiation five years ago and reirradiated three years ago because of emergence of abnormal shadow suspecting of lung metastasis.<BR>As for <I>M. tuberculosis</I> sputum obtained by bronchoscopy were negative in both cases at the beginning, lung metastases were strongly suspected until tubercle was verified from bone marrow three weeks later prior to the admission on the first case and positive sputum for tubercle bacilli was obtained by bronchofiberscope one year later on the second case.<BR>Particular emphasis has been laid on the risk of exacervation of lung tuberculosis in these patients with various cancer and dormant tuberculous foci when receiving anticancer therapy.
日本結核病学会の論文