Objective  To investigate the clinical characteristics and computed tomography (CT) features of patients with lung cancer complicated with pulmonary tuberculosis.

  Methods  We retrospectively analyzed these data, such as those on clinical characteristics, relationship between cancer lesions and tuberculosis focus, time of confirmed diagnosis, pathological type of lung cancer, and diagnostic methods, of 298 patients with pulmonary tuberculosis complicated with lung cancer who were admitted to Shanghai Pulmonary Hospital between February 2000 and February 2015.

  Results  Pulmonary tuberculosis complicated with lung cancer was more common in old male patients. Blood-stained sputum was the main clinical characteristic in these patients, and CT showed that most nodular lesions were localized in the upper lobe. Some lesions presented as masses. The number of patients with lesions localized in the same lobe of the ipsilateral lung was 37 (12.4%, 37/298). The lesions of pulmonary tuberculosis and lung cancer were localized in different lobes in 138 cases (46.3%, 138/ 298). In 123 (41.3%, 123/298) cases, some lesions of pulmonary tuberculosis and lung cancer partially overlapped. There were 120 patients diagnosed with lung cancer after pulmonary tuberculosis was confirmed, and 28 patients were diagnosed with pulmonary tuberculosis after lung cancer was confirmed. One hundred and fifty patients were diagnosed with pulmonary tuberculosis and lung cancer within no more than two months. The mean time of confirmed diagnosis was 10.9-126 months. The major pathological type was non-small cell lung cancer. Sputum examination and fiberoptic bronchoscopic brushing were primary methods to detect tumor cells.

  Conclusions  Patients with pulmonary tuberculosis complicated with lung cancer presented with some special clinical characteristics and CT features. Earlier diagnosis may contribute to prompt treatment and improved prognosis synchronously.