Differential diagnosis of lung cancer and pulmonary tuberculosis

Lung cancer patients may present with a variety of clinical manifestations depending on the location of the tumor, pathological type, and course of the disease, which can be easily confused with other lung diseases. The key points for distinguishing lung cancer from tuberculosis are as follows:

1. Differentiation between pulmonary tuberculoma and peripheral lung cancer

Pulmonary tuberculoma is more common in young people. Generally, the course of the disease is long and the development is slow. The lesions are mostly located in the posterior segment of the apex of the upper lobe or the dorsal segment of the lower lobe. The density of the shadows on the X-ray film is uneven, and translucent areas and calcification points can be seen. There are often other scattered tuberculosis lesions in the lungs. Lung cancer is more common in middle-aged and elderly people. The X-ray manifestation is isolated shadows in the lung field with rough edges and fine and short spiculated shadows.

2. Differentiation between miliary tuberculosis and diffuse bronchioloalveolar carcinoma

Miliary tuberculosis is more common in young people, with obvious systemic toxicity symptoms. Anti-tuberculosis drug treatment can improve symptoms and the lesions gradually disappear. The X-ray manifestation of diffuse bronchioloalveolar carcinoma is an infiltrative lesion with blurred outlines, similar to pneumonia.

3. Differentiation between hilar lymph node tuberculosis and central lung cancer

The X-ray manifestations of hilar lymph node tuberculosis and central lung cancer are very similar, and the differentiation mainly depends on medical history and other examinations. Hilar lymph node tuberculosis is more common in adolescents, often with symptoms of tuberculosis infection, and rarely with hemoptysis; central lung cancer is more common in middle-aged and elderly people over 50 years old, and often with symptoms such as blood in sputum, a small amount of hemoptysis, chest tightness, shortness of breath, fever, chest pain, etc.