Scimago Lab
powered by Scopus
call: +1.631.470.9640
Mon-Fri 10 am - 2 pm EST


Medical Science Monitor Basic Research


eISSN: 1643-3750

Get your full text copy in PDF

Does Every Necrotizing Granulomatous Inflammation Identified by NSCLC Resection Material Require Treatment?

Fatih Yakar, Aysun Yakar, Nur Büyükpınarbaşılı, Mustafa Erelel

(Department of Pulmonary Medicine, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey)

Med Sci Monit 2016; 22:1218-1222

DOI: 10.12659/MSM.897638

BACKGROUND: Lung cancer and tuberculosis (TB) are two major public health problems. They can coexist or appear sequentially. In patients with TB, lung cancer risk is increased. However, vice versa is not crystal clear. In this study, we aimed to determine the development of TB in patients with resectabled non-small cell lung cancer (NSCLC) in a 2-year postoperative follow-up period.
MATERIAL AND METHODS: We conducted a retrospective cohort study at three university hospitals. Patients who had NSCLC surgery between 2009 and 2013 were included and patient records were reviewed for the presence of necrotizing granulomatous inflammation (NGI) in resected specimens. Demographic properties, tumor type, stage, location, type of surgery, tuberculosis history, and thorax CT findings were recorded. We searched for the development of tuberculosis within a 2-year period after surgery.
RESULTS: A total of 1027 patient cases were reviewed, of which 48 patients had NGI. The median age was 63 years. The most common type of cancer was squamous carcinoma; and lobectomy was the preferred operation (70.8%). Cancer involvement most commonly included the right lung (61.8%) and upper lobes (47,9%). Only 11 patients had anti-TB treatment postoperatively, which was based on radiological findings. Prior tuberculosis or anti-TB history, type, stage or localization of cancer, and adjuvant/neoadjuvant therapy were not found to be related to TB treatment. None of the study population had TB during the two-year follow-up period.
Treatment decisions appeared mostly related to physician experience. There was no difference in the risk of developing TB between patients with or without treatment. This finding may change the management of our patients.
CONCLUSIONS: Every NGI discovered in NSCLC resected material does not always require anti-TB treatment.

Keywords: Antitubercular Agents - administration & dosage, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung - surgery, Cohort Studies, Granuloma - pathology, Inflammation - therapy, Lung Neoplasms - surgery, Necrosis - pathology, Tomography, X-Ray Computed, Tuberculosis - pathology

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree