title: Carcinomatous pleuritis and pericarditis accompanied by pulmonary tuberculosis.
abstract: Although both lung cancer and pulmonary tuberculosis (TB) commonly occur in clinical practice, little attention has been paid to their coexistence. A 62-year-old female was admitted with acute dyspnoea secondary to cardiac tamponade. During her admission, a mass lesion harbouring air bronchograms in the right upper lobe rapidly increased in size. Surgical lung, pericardial, and pleural specimens yielded TB from a nodule in the right upper lobe and lung adenocarcinoma from the pericardium and pleura. Anti-tuberculous therapy was administered and gefitinib was subsequently started after the positive identification of epidermal growth factor receptor (EGFR) mutation (exon 19 deletion). The patient's general condition gradually improved with the anti-tuberculous and the EGFR-tyrosine kinase inhibitor (EGFR-TKI) treatment. Dual pathology is important to consider in patients with atypical radiological appearances. In those with proven EGFR mutation positive for lung cancer and pulmonary TB, sequential anti-tuberculous medication followed by EGFR-TKI treatment is advised.
authors.affiliation: Department of Respiratory Medicine Juntendo University Shizuoka Hospital Shizuoka Japan.
authors.forename: Munechika
authors.initials: M
authors.lastname: Hara
authors.affiliation: Department of Respiratory Medicine Juntendo University Shizuoka Hospital Shizuoka Japan.
authors.forename: Shin-Ichiro
authors.initials: SI
authors.lastname: Iwakami
authors.affiliation: Department of Respiratory Medicine Juntendo University Shizuoka Hospital Shizuoka Japan.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Matsumoto
authors.affiliation: Department of Respiratory Medicine Juntendo University Shizuoka Hospital Shizuoka Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Miyawaki
authors.affiliation: Department of Pathology Juntendo University Shizuoka Hospital Shizuoka Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Wada
authors.affiliation: Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
keywords: Epidermal growth factor receptor; carcinomatous pericarditis; carcinomatous pleuritis; lung cancer; pulmonary tuberculosis