Farwell D J, Rutledge L J, Bryant L R, Schechter F G
South Med J. 1978 Apr;71(4):377-9. doi: 10.1097/00007611-197804000-00010.
The pronounced predilection of bronchogenic carcinoma for tuberculous lobes of the lungs is not generally recognized. In this plus 11 other series of patients with coexisting disease, an average of 52% had the neoplasm in a tuberculous lobe. In the present study, tuberculosis was confined to one or two lobes in 24 of 27 patients (89%) with coexisting disease; 21 (88%) of these patients had the neoplasm in a tuberculous lobe. Diagnosis required an average of 1.8 months (one week to 18 months). A low index of suspicion can delay diagnosis of the carcinoma until hilar enlargement, tumor, or metastasis is apparent radiologically, By then, often the tumor has become inoperable. Our data suggest that carcinoma should be suspected in a tuberculous man of cancer age who smokes and who has a lesion which is enlarging, is in an unusual location, or is drug resistant. Cytologic study of sputum, bronchoscopy, and early thoractomy are advocated.
支气管源性癌对肺结核叶的明显偏好尚未得到普遍认可。在这组以及其他11组患有并存疾病的患者系列中，平均有52%的患者肿瘤位于结核叶。在本研究中，27例患有并存疾病的患者中有24例（89%）的结核病局限于一个或两个肺叶；其中21例（88%）患者的肿瘤位于结核叶。诊断平均需要1.8个月（1周至18个月）。怀疑指数低会延迟癌症的诊断，直到在放射学上出现肺门增大、肿瘤或转移，到那时，肿瘤往往已无法手术切除。我们的数据表明，对于患有癌症年龄、吸烟且有病变正在增大、位置异常或耐药的结核病患者，应怀疑患有癌症。提倡对痰液进行细胞学研究、进行支气管镜检查和早期开胸手术。
