Histomorphological features of combined forms of tuberculosis and lung cancer.

Y. F. Savenkov, Y. F. Koshak, I. A. Malcev, I. V. Korpusenko, P. E. Bakulin


The were studied pathological features of combined forms of tuberculosis and non-small cell lung cancer in 72 patients who underwent radical surgical resection interventionsfrom transsternal access with mediastinal lymph node dissection, with predominanceof pneumonectomy - 63.9%. There were identified three main categories of pathological changes: cancer on the background of post-tuberculosis changes, cancer in tuberculoma, cancer in the wall of the active cavity. Post-tuberculosis changes were presented by dense centers, fibrosis, cirrhosis areas, sanitized cavities with histological predominance of coarse fiber connective tissue with giant cellgranulomas, with areas characterized by the appearance of the lung tissue with atypical proliferation and metaplasia of bronchopulmonary epithelium, which is a precancerous condition. This malignant tumor process was presented mainly by adenocarcinomas and squamous cell cancer and differred by polymorphic macro- and microscopic picture. Cancer intuberculoma and fibrous wall cavity differed by pronounced activity of tuberculosis process in the form of lymphohistiocytic infiltration, foci of caseous necrosis and presence of expressed granulation layer of Pirogov-Langhans’cells. The basic morphological causes of carcinogenesis due to secondary changes of lung tissue in patients with tuberculosis were determined. The features of metastasis of malignant tumors on the background of specific tuberculous and post-tuberculosis changes in regional lymph nodes and the interrelation between the frequency of metastatic lesions with severity of tuberculosis and post-tuberculosis changes in them were studied; this has clinical significance in the surgical treatment of patients with concomitant forms of tuberculosis and lung cancer.


pulmonary tuberculosis; lung cancer; post-tuberculosis changes; bronchopulmonary and mediastinal lymph nodes

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1. Borodulin BE. [Comorbidity cancer and pulmo­nary tuberculosis]. Vopr. Onkologii. 2006;1:105-6. Russian.

2. Boyarkin GM. [Clinic, diagnostics and treatment of non-small cell lung cancer in combination with tuberculosis]. Dis. kand. med. nauk. 2006;34-35. Russian.

3. Opanasenko MS, Kupchak ІM, Kshanovs'kiy OE. [Diatomaceae as a method of choice for determining the etiology of lymphadenopathy syndrome votron and an al­gorithm for its optimal use]. Ukr. pul'monol. zhurn. 2016;4:42-46. Ukrainian.

4. Opanasenko MS, Konіk BM, Levanda LІ, Zaga­ba LM. [The combination of tuberculosis and lung cancer: state of the problem and a clinical case]. Ukr. pul'monol. zhurn. 2016;3:68-70. Ukrainian.

5. Raznatovskaya EN, Prosvetov YuV, Pisaren­ko TD. [The urgency of the problem of combined flow of tuberculosis and lung cancer]. Zaporozhskiy meditsinskiy zhurnal. 2015;13(2):42-43. Russian.

6. Kshanovs'kiy OE, Opanasenko MS, Pavlyuk ІM, Zagaba LM. [The role of videothoracoscopy and open biopsy for the morphological diagnosis of diffuse lung diseases]. Ukr. pul'monol. zhurn. 2014;1:50-51. Ukrainian.

7. Tsvetkova OA, Pozdnyakova NA. [Difficulties of differential diagnostics of tuberculosis and lung cancer in the presence of cavitary education]. Med. pomoshch'. 2005;2:19-23. Russian.

8. Aoki K. Excess incidence of lung cancer among pulmonary tuberculosis patients. Jpn J Ctin Oncol. 2013;23(4):205-20.

9. Bhatt MLB. Pulmonary tuberculosis as dif­ferential diagnosis of lung cancer. Diagnostic dilemia. 2012;1(1):36-42.

10. Chandrasekhar HR. Bronchioloalveolar carci­noma mimicking military tuberculosis. J. Assoc. Phy­si­cians. India. 2001;49:281-2.

11. Cicenas S. Lung cancer in patients with tu­bercu­losis. World Journal of Surgical Oncology. 2007;5:22.

12. Endri M. Differential diagnosis of lung nodules: breast cancer metastases and lung tuberculosis. Infez Med. 2010;18(1):39-42.

13. Kumar R, Gupta N. [Role of bronchoscopy in evaluation of cases with sputum smear negative pulmo­nary tuberculosis, interstitiallung disease and lung mali­gnancy: A retrospective study of 712 cases]. Indian J Tu­berculosis. 2015;62(1):36-42.

14. Vento S, Lanzafame M. Tuberculosis and cancer: a complex and dangerous liaison. Lancet Oncol. 2011;12:520-2.

GOST Style Citations

  1. Бородулин Б.Е. Сочетанные заболевания ра­ком и туберкулезом легких / Б.Е. Бордулин // Вопр. онкологии – 2006. – №1. – С. 105–106.
  2. Бояркин Г.М. Клиника, диагностика и лечение немелкоклеточного рака лёгких в сочетании с ту­беркулёзом: автореф. дис. на соискание учен. степени канд. мед. наук / Г.М. Бояркин. –Санкт-Петербург, 2006. – 26 с.
  3. Відеоторакоскопія як метод вибору при вста­новленні етіології синдрому внутрішньогрудної лімфаденопатії та алгоритм її оптимального засто­сування / М.С. Опанасенко, І.М. Купчак, О.Е. Кша­новський [та ін.] // Укр. пульмонол. журнал. – 2016. – № 4. – С. 42–46.
  4. Поєднання туберкульозу і раку легень: стан проблеми і клінічний випадок / М.С. Опанасенко, Б.М. Конік, Л.І. Леванда, Л.М. Загаба // Укр. пуль­монол. журн. – 2016. – № 3. – С. 68–70.
  5. Разнатовская Е.Н. Актуальность проблемы со­четанного течения туберкулеза и рака легких / Е.Н. Раз­на­товская, Ю.В. Просветов, Т.Д. Писаренко // Запорож. мед. журнал. – 2015. – Т. 13, № 2. – С. 42-43.
  6. Роль відеоторакоскопії та відкритої біопсії для морфологічної діагностики дифузних захворювань ле­гень / О.Е. Кшановський, М.С. Опанасенко, І.М. Пав­люк, Л.М. Загаба // Укр. пульмонол. журнал. – 2014. – № 1. – С. 50-51.
  7. Цветкова О.А. Сложности дифференциальной диагностики туберкулеза и рака легкого при наличии полостного образования / О.А. Цветкова, Н.А. Поз­днякова // Мед. помощь – 2005. – № 2. – С. 19–23.
  8. Aoki K. Excess incidence of lung cancer among pulmonary tuberculosis patients / K. Aoki // Jаpn J. Clin. Oncol. – 2013. – Vol. 23, N 4. – P. 205-220.
  9. Bhatt M.L.B. Pulmonary tuberculosis as diffe­rential diagnosis of lung cancer / M.L.B. Bhatt // Diag­nostic dilemia. – 2012. – Vol. 1, N 1. – P. 36-42.
  10. Chandrasekhar H.R. Bronchioloalveolar carci­noma mimicking military tuberculosis / H.R. Chan­drasekhar // J. Assoc. Physicians.India. –2001. –Vol. 49. –P. 281–282.
  11. Cicenas S. Lung cancer in patients with tuberculosis /S. Cicenas// World J. Surgical Oncology.-2007.- N 5.-P.22.
  12. Endri M. Differential diagnosis of lung nodules: breast cancer metastases and lung tuberculosis // Infez. Med. – 2010. – Vol. 18, N 1. – P. 39–42.
  13. Kumar R. Role of bronchoscopy in evaluation of cases with sputum smear negative pulmonary tuber­cu­losis, interstitiallung disease and lung malignancy: A ret­rospective study of 712 cases / R. Kumar,N. Gupta// In­dian J. Tuberculosis. – 2015. – Vol. 62, N 1. – P. 36-42.
  14. Vento S. Tuberculosis and cancer: a complex and dangerous liaison / S. Vento, M. Lanzafame // Lancet Oncol. – 2011. – N 12. – P. 520-522.


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