Carcinomatous pleuritis and pericarditis accompanied by pulmonary tuberculosis.

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. [ABSTRACT FROM AUTHOR]