title: Disseminated tuberculosis in a patient with recurrent transitional cell carcinoma of renal pelvis and bladder following intravesical BCG therapy: A report of a rare case.
abstract: Bacillus Calmette-Guerin (BCG) has been used as an intravesical instillation for nonmuscle invasive (superficial) bladder cancer for the last 3 decades. Although intravesical BCG therapy is well-tolerated by most of the patients, adverse reactions have also been reported which are usually local, benign, and self-limited. Systemic complications such as miliary tuberculosis (TB) are very rare with few documented reports in literature. We hereby report a rare case of disseminated TB in bilateral lungs, adrenal, cervical, mediastinal, and para-aortic lymph nodes in a patient with recurrent transitional cell carcinoma (TCC) of renal pelvis and urinary bladder. Peculiar feature of this case was the development of TB 2 years following last BCG instillation, which is unlike most of the cases in the literature where TB developed within few weeks of last dose of BCG.
authors.forename: Mukta
authors.initials: M
authors.lastname: Pujani
authors.forename: Sabina
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Jetley
authors.forename: Prabhat Kumar
authors.initials: PK
authors.lastname: Raina
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D010386:Pelvic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D014376:Tuberculosis / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D001500:BCG Vaccine