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Forum Name: Lung Cancer

Question: Lung cancer v/s TB on ct scan??


 beachfamily5 - Fri Jun 01, 2007 8:18 am

My 61 yo mom had a chest xray last week due to a cough and trouble breathing for 2 weeks (non smoker). After the breathing trouble she did develop a high fever for about 4 days then went on zithromax and that fever went away.Xray showed mass on left lung. Then she had a ct scan yesterday .Her results state abnormal ct scan. Mass left lun 4"x4"x2" and multiple metasizes in right lung of various size. Nodule on chest. 12mm nodule in left breast.Swollen lymph nodes.No lesions liver or spleen. Normal cea bloodwork.
Her doctor said possibilities are TB . Or llung,breast,or lymphoma cancers.We are confused on the TB .He is not suggesting testing her for TB. I have 3 small kids she has been around and am now concerned if that is a real possibility.Can that prsent on ct like this? She gets a biopsy Monday.

I read these results to mean a stage III or IV cancer.Can you interpret what these results would mean to you? thank you.
 Dr. A. De la Guerra - Thu Jun 14, 2007 10:39 pm

User avatar Hi beachfamily5,

The bacterium that causes tuberculosis is Mycobacterium tuberculosis, an infection that primarily affects the lungs. TB specifically refers only to disease caused by M. tuberculosis, but other mycobacteria occasionally infect humans, like M. avium and M. intracellulare causing the Mycobacterium avium complex (MAC) disease.

Pulmonary TB may exhibit a variety of radiological features and may imitate other lung diseases, including cancer. Cough, fever and shortness of breath are common symptoms of active pulmonary TB, but high fever is not usual; typically there is a slight fever accompanied by night sweats and chills. Additionally, the fact that fever went away after a short course of azithromycin only is not consistent with TB. Standard therapies commonly used for bacterial infections, like azithromycin (Zithromax) do not work in tuberculosis, although azithromycin have been found to be effective against MAC disease when used in combination with other drugs, but after months of treatment.

Concerning the diagnostic options, the chest CT shows a mass in the left lung, and multiple nodules in the right lung for which the radiologist precisely uses the term metastases to describe them in the report. Also, a 12 mm nodule was found in the left breast. Thus, I consider that TB is not the first diagnostic possibility, neither lymphoma. Unfortunately, the outcome and the radiological findings you have described are more consistent with a cancerous disease, lung cancer more likely. Except for size, I do not have the attributes of the breast nodule, but if distinct clinical or radiological characteristics of benignity are absent, breast cancer with pulmonary metastases may well be an option. But as I said before, TB may mimic other diseases.

On your question about my interpretation of the results, it could be either stage IV lung or breast cancer. I truly hope to be wrong.
 beachfamily5 - Wed Oct 31, 2007 12:49 pm

Thank you to the doctor for replying and all the info. It did turn out to be stage IV lung cancer as you suspected.We were surprised since she is a non smoker. My mom is undergoing chemo now, doing very well in terms of tolerating the treatments.

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