Exploring Tuberculosis in Cancer Patients Undergoing Bronchoscopy

Abstract Introduction: The absence of respiratory symptoms in cancer patients often leads to the omission of tuberculosis (TB) diagnosis. However, the clinical characteristics of those who have both TB and cancer are unknown. Therefore, our study describes a cohort of patients who underwent bronchoscopy with oncological and TB diagnoses. Methods: We conducted a descriptive observational study that included patients with confirmed TB diagnosis between January 2023 and August 2024. We included patients with neoplastic diseases who underwent diagnostic bronchoscopy at a high-complexity center, where granulomatous infection or TB was not suspected at any time before the procedure. The diagnosis of pulmonary TB was confirmed through molecular biology testing using the GeneXpert MTB/RIF technique. Results: Eighteen patients were included, with a mean age of 50.3 years (SD 20.4). 55.6% were women. The indications for bronchoscopy were 22.2% for pulmonary mass, 38.9% for interstitial/alveolar infiltrate, 11.1% for fever, 16.7% for pulmonary nodules, and 11.1% for consolidation. Regarding prior oncological diagnosis, 62.5% had solid tumors and 37.5% had leukemia or lymphoma. 22.2% were in stage II, 72.2% in stage III, and 5.6% in stage IV. In the study, 16.7% of participants had a positive Tuberculin purified protein derivative (PPD) test. Leukopenia was observed in 22.2%, while leukocytosis and neutrophilia were reported in 5.6% each. No cases of positive bacilloscopy were reported. 55.6% showed alveolar/interstitial infiltrate, 27.8% had masses, 16.7% had nodules, and 22.2% showed lymphadenopathy on chest X-ray images. Conclusion: In our study of 18 patients with a mean age of 50.3 years, the majority were women with multiple comorbidities. Bronchoscopy was primarily performed for pulmonary masses and infiltrates. 16.7% showed a positive PPD test, but no cases of positive bacilloscopy were found, highlighting the complexity of these diagnoses. Table. General characteristics of the population. Notes: m(SD): Mean (Standard Deviation); n(%): Number (Percentage); BMI: Body Mass Index; COPD: Chronic Obstructive Pulmonary Disease; ESR: Erythrocyte Sedimentation Rate; AST: Aspartate Aminotransferase; ALT: Alanine Aminotransferase