{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T12:33:17Z","timestamp":1787142797439,"version":"build-2736575974"},"reference-count":114,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Although antibiotic therapy effectively cures active tuberculosis (TB), many survivors are left with permanent lung damage and long-lasting immune alterations. Growing epidemiological evidence indicates that individuals with prior pulmonary TB have a two- to three-fold increased risk of lung cancer, independent of smoking, suggesting mechanisms beyond shared risk factors. This review advances the concept that TB imprints a durable \u201cmemory\u201d within the lung, characterized by persistent structural remodeling and immune reprogramming that together create a tumor-permissive microenvironment. We synthesize evidence showing that TB granulomas act as dynamic immune niches that induce hypoxia, fibrosis, and immune exhaustion, features that frequently persist after microbiological cure. Post-TB sequelae including fibrotic scarring, cavitation, bronchiectasis, and vascular remodeling, promote chronic inflammation, oxidative DNA damage, and mechanotransduction pathways linked to oncogenesis. Concurrently, sustained T-cell exhaustion, macrophage polarization toward tumor-associated phenotypes, and impaired antigen presentation weaken tumor surveillance. We further discuss emerging roles for lung microbiome dysbiosis in sustaining inflammation. Collectively, these processes provide a mechanistic framework linking healed TB to lung carcinogenesis and highlight TB survivors as a distinct population for targeted surveillance and preventive strategies.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1889276","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T12:12:31Z","timestamp":1787141551000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From granulomas to tumors: post-tuberculosis immune and structural lung remodeling as a driver of carcinogenesis"],"prefix":"10.3389","volume":"17","author":[{"given":"Praise Audax","family":"Rukonge","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jiangyin Clinical College of Xuzhou Medical University","place":["Wuxi, Jiangsu, 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