Concomitant discovery of lung cancer and tuberculosis in a cannabis smoker

Introduction. - The coexistence of lung cancer and active tuberculosis is relatively rare. We report a case of concomitant discovery of lung cancer and tuberculosis in the context of addiction to tobacco and cannabis. Observation. - A 50-year-old man, smoking tobacco and cannabis since the age of 18, was hospitalized for hemoptysis. Physical examination revealed cachexia, hyperthermia and decreased breath sounds on auscultation of the left lung field. The chest X-ray objectified atelectasis of the left upper lobe. The CT scan revealed a left upper lobe atelectasis and a cavity surrounded opacities taking a tree in bud appearance located at the apex of the left lower lobe. Endoscopy showed an obstruction by a bud located at the upper left lobe. Histology of bronchial biopsy revealed squamous cell carcinoma. Direct examination of bacteriological samples found BAAR and culture confirmed tuberculosis. The contamination could occur via a close relative, smoking cannabis and being treated for tuberculosis. After a 6-month treatment for tuberculosis, the patient underwent a course of chemotherapy, but refused further treatment. Death occurred 3 months later. Conclusion. - This observation relates the concomitant discovery of lung cancer and tuberculosis. It also highlights the possible role of cannabis addiction in the transmission of tuberculosis and the occurrence of lung cancer in combination with tobacco. (C) 2015 Elsevier Masson SAS. All rights reserved.