Lymph Node Lesion in a Patient with Bronchial Cancer and Tuberculosis: is it a Metastasis or Lymph Node Tuberculosis?

Despite the progress and advancements made in the management of bronchial cancer, the prognosis is quite reserved, especially in the terminal stages, and in the case of certain comorbidities, such as tuberculosis, which is still present in our country. The problem with this situation lies in the diagnostic phase, and sometimes at the therapeutic stage. Case report: we describe the case of a hypertensive patient, recently diagnosed with bronchial cancer and lymph node tuberculosis. One month after the beginning of anti-tuberculosis treatment, mediastinal lymph nodes showed increased metabolism on the 18F-FDG PET scan, while other lymph nodes disappeared. The staging of the cancer as well as the therapeutic strategy became difficult, especially since bronchial endoscopic ultrasound is not part of our usual practice. Conclusion: The complexity of diagnosis in patients with lung cancer associated with tuberculosis delays treatment, and consequently, the prognosis could become more unfavorable.