Can Tuberculosis Infection After Liver Transplant Induce Lung Squamous Cell Carcinoma from Squamous Metaplasia of Alveolar Epithelium?

This case report describes a 65-year-old male patient with hepatocellular carcinoma who received an orthotopic liver transplant. One month after surgery, the patient was treated for tuberculosis due to the fever. At 16 months after the operation, a chest computed tomography scan revealed a mixed ground-glass nodule at the apex of the right upper lobe, which gradually grew from 5 mm to 10 mm and then was removed via thoracoscopy. Pathology examination revealed extensive squamous metaplasia of the alveolar lumen, with focal areas of malignant transformation of the squamous epithelium into moderately differentiated squamous cell carcinoma. This study highlighted the increased risks of tuber-culosis infection and lung cancer in liver transplant recipients because of use of immunosuppressive drugs, which presented as a rare case of carcino-genesis based on alveolar epithelial squamous metaplasia.