A Case of Hypertrophic Pulmonary Osteoarthropathy in Coexistent Non-small Cell Lung Carcinoma and Pulmonary Tuberculosis

The coexistence of two conditions producing hypertrophic pulmonary osteoarthropathy (HPOA) is rare. In this case, the patient has pulmonary tuberculosis (PTB) and bronchogenic carcinoma, both of which can contribute to HPOA separately. A 69-year-old male presented with pain and swelling of wrist and fingers of both hands. The patient has a history of smoking. On examination, the patient had grade IV clubbing, minimal crepitations and wheeze on right side, and decreased breath sounds on left side. X-ray of the wrist showed new bone formation, and chest X-ray showed right upper lobe nonhomogeneous opacities and a left lower lobe mass lesion. Contrast-enhanced computed tomography (CECT) confirmed the same. Bronchial washing and sputum samples were sent for cartridge-based nucleic acid amplification test (CBNAAT) and came out as positive. Computed tomography (CT)-guided fine needle aspiration cytology (FNAC) from left lower lobe mass lesion revealed non-small cell lung carcinoma. It is quite rare for PTB and lung cancer to coexist. Though PTB rarely produces HPOA, this patient has HPOA with coexisting PTB and non-small cell lung carcinoma. It is more plausible to think HPOA is due to bronchogenic carcinoma than PTB.