A case of pleural tuberculosis following lobectomy for lung cancer

We report a rare case of pleural tuberculosis after lobectomy for lung cancer. A 67-year-old man without a history of pleural tuberculosis developed lung cancer with cStage IA2 (T1bN0M0). We performed thoracoscopic right upper lobectomy with the dissection of lymph nodes. Intraoperative pleural effusion cytology confirmed malignant cells, and the pathological stage was IVA (T1bN1M1a). The patient was treated with postoperative chemotherapy (Carboplatin+Pemetrexed 6 courses). Rt. pleural effusion disappeared 4 months after the surgery, but a follow-up chest radiograph and chest computed tomography (CT), 8 months after surgery, showed rt. pleural effusion. Pleural effusion cytology did not confirm malignant findings, but a polymerase chain reaction (PCR) test of pleural effusion and pleural effusion culture for Mycobacterium tuberculosis were positive. Anti-tuberculosis drugs were administered for 6 months. He has been followed up without the relapse of pleural tuberculosis. We must include pleural tuberculosis in the differential diagnosis of pleural effusion in patients receiving surgery for lung cancer.