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Background : Tuberculosis is a chronic infectious disease and can be categorised into pulmonary TB and extra-pulmonary TB based on its spread. TB lymphadenitis is one of the extra-pulmonary TB diseases. Patients with a weakened immune system in systemic lupus erythematosus (SLE) have an increased incidence of TB. Case : Here we present a case report of a 21-year-old female patient with SLE diagnosed with tuberculous lymphadenitis at dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia. The patient complained of a lump in the right neck 4 months ago with a diameter of 4 cm, accompanied by fever, decreased appetite, and weight loss. Other than that, the patient also experiences joint pain, hair loss and sun sensitivity since 12 months ago. Chest radiography showed no abnormalities, and fine-needle aspiration biopsy results confirmed tuberculous lymphadenitis. Antinuclear antibody test was borderline. The patient had been taking steroids and hydroxychloroquine for the past 10 months. Currently, the patient is taking the advanced phase of antituberculosis drugs FDC. After undergoing the intensive phase of antituberculosis drugs, the submandibular lump got smaller to a diameter of 2 cm. Conclusion : TB lymphadenitis is a rare case but can occur in conditions of decreased immunity like SLE. It involves some of the immune disorders caused by the long-term use of immunosuppressive therapy., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Arliny Y et al.)

Pulmonary tuberculosis and lung cancer are public health problems, causing significant morbidity and mortality worldwide. The coexistence of the two diseases has rarely been reported while their causative association has been noticed leading to diagnosis delayed and prognosis worsening. In this case report, we present the case of a patient with coexistence of pulmonary tuberculosis and small cell lung carcinoma. A 54-year-old male was presented with the complained of lower left chest pain for six months, which was getting worse four days before admission to the hospital. The patient also complained of cough and decreased appetite and weight loss. Initial chest X-ray revealed an infiltrate and cavity in the upper right lung and inhomogeneous consolidation in the left paracardial. After the patient was diagnosed with pulmonary tuberculosis and was given anti-tuberculosis drugs for two months, the cavity and consolidation decreased with no clinically significant improvement. We performed a bronchoscopy with suspicion of lung cancer and a forcep biopsy in which small cell carcinoma was confirmed. The patient received two cycles of chemotherapy and anti-tuberculosis was continued for four months. During the observation in the fourth month, there was a reduction in the tumor size. This case highlights that similarity of clinical symptoms between pulmonary tuberculosis and lung cancer often lead to misdiagnosis of both. Therefore, in the absence of complete clinical and radiological improvement in pulmonary tuberculosis patients, the coexistence of lung cancer should be considered. This also highlights that early diagnosis is critical for the favorable outcome., Competing Interests: Authors declare no conflict of interest., (© 2023 The Author(s).)