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Being mindful of the extra baggage

We treated a 59-year-old, ex smoker who presented with right sided chest pain and progressive breathlessness. Chest X-ray showed a mass in the right lower zone with effusion. Computed tomography (CT) scan demonstrated a mass in the right lower lobe with effusion and subcarinal adenopathy. Malignancy was suspected. Bronchoscopy revealed an extensive narrowing of the middle lobe bronchus, BAL and TBLB was taken from the right middle and lower lobe, favouring adenocarcinoma with concomitant necrotising granulomatous inflammation. Biopsy and BAL detected concomitant MTB and malignancy.


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