A case of triple synchronous lung cancer in the same lobe associated with old pulmonary tuberculosis

Abstract

The patient was a 49-year-old man with a history of pulmonary tuberculosis treated at the age of 20. He was referred to our hospital after a routine checkup revealed abnormal shadows on chest imaging. CT revealed an old tuberculous lesion with calcification and 3 pulmonary nodules in the right upper lobe. A biopsy of 1 of the nodules confirmed a diagnosis of a typical carcinoid tumor. The patient underwent robot-assisted right upper lobectomy with mediastinal lymph node dissection. Histopathological examination revealed that the remaining 2 lesions were papillary adenocarcinoma and large cell neuroendocrine carcinoma. This is a rare case of synchronous triple primary lung cancers of different histological types arising in the right upper lobe against a background of old pulmonary tuberculosis in a middle-aged patient. The case suggests a possible association between prior tuberculosis and lung carcinogenesis.