A Rare Case Of Synchronous Mycobacterium Tuberculosis, Aspergillosis And Lung Adenocarcinoma In A Patient

Pulmonary tuberculosis, pulmonary aspergillosis and lung cancer are amongst the most common causes of pulmonary cavities; however, concurrence of all three in a patient is rare. We report a case of a 52-year-old woman presented with chronic cough and intermittent blood-stained sputum who has been diagnosed as pulmonary tuberculosis 6 months earlier before admission with failed initial anti-tuberculosis therapy. CT-guided biopsy targeted at the periphery lower lobe cavity of the right lung was carried out to diagnose choronic cavitary pulmonary aspergillosis, nevertheless, 3 month anti-fungal therapy with voriconazole failed. Thus, the bronchoscopy was performed again, lung adenocarcinoma was diagnosed and the treatment with gefitinib was effective. Our case is a rare one presenting with the synchronous Mycobacterium tuberculosis, aspergillosis infection and lung adenocarcinoma in a patient. Physicians should be aware of malignancy when previous therapeutic effect for pulmonary cavity is poor.