PDF(Pubmed)
Abstract：
Tuberculosis can coexist with malignancy in the same organ, but cancer with TB in the cervix is rare. This is a case of cervical tuberculosis diagnosed in a cervical cancer patient after concurrent chemoradiotherapy and brachytherapy. This is the case of a 38-year-old G2P2 (2002) diagnosed with squamous cell carcinoma, large cell non-keratinizing cervix, Stage IIIB. The patient underwent concurrent chemoradiotherapy and brachytherapy. One month after the last brachytherapy dose, the attending physician noted a nodularity on the anterior lip of the cervix. A cervical punch biopsy was done to rule out tumor persistence. The histopathology revealed chronic granulomatous inflammation with Langhan\'s type multinucleated giant cells consistent with tuberculous infection. She was diagnosed with cervical tuberculosis, postulated to be from latent TB reactivation, and was given Anti-Koch\'s medication for six months. After receiving Anti-Koch\'s treatment, the cervical nodularity was no longer appreciated, and the rest of the cervix was smooth on palpation. Her Pap Test was negative for any intraepithelial lesion and was declared with no evidence of carcinoma. A possible latent TB infection should always be screened in cancer patients from high-burden areas or those with close contact treated for tuberculosis because immunosuppression during cancer treatment can cause the reactivation of tuberculous disease. Cervical tuberculosis complicating cervical malignancy is treatable with Anti-Koch\'s therapy and has not been shown to affect the course of the carcinoma.
摘要：
结核病可以在同一器官中与恶性肿瘤共存，但是子宫颈有结核病的癌症很少见。这是在同步放化疗和近距离放射治疗后在宫颈癌患者中诊断出的宫颈结核病例。这是38岁的G2P2（2002）诊断为鳞状细胞癌的案例，大细胞非角化子宫颈，IIIB阶段。患者接受了同步放化疗和近距离放射治疗。最后一次近距离放射治疗后一个月，主治医师注意到子宫颈前唇有结节。进行了宫颈穿刺活检以排除肿瘤的持久性。组织病理学显示慢性肉芽肿性炎症，伴有朗汉型多核巨细胞，符合结核性感染。她被诊断出患有宫颈结核,假定是由于潜伏性结核病的再激活，并给予抗科赫药物治疗六个月。在接受抗科赫治疗后，宫颈结节不再被重视，触诊时子宫颈其余部分光滑。她的巴氏试验对任何上皮内病变均为阴性，并且被宣布没有癌症的证据。应始终在高负担地区的癌症患者或与结核病密切接触的患者中筛查可能的潜伏性结核病感染，因为癌症治疗期间的免疫抑制会导致结核性疾病的重新激活。宫颈结核合并宫颈恶性肿瘤可以用抗Koch疗法治疗，但未发现影响癌的病程。
