Bronchoscopic, radiologic and pulmonary function evaluation of endobronchial tuberculosis

Area of Science:

• Pulmonology
• Infectious Diseases
• Medical Imaging

Background:

• Endobronchial tuberculosis (EBTB) presents diagnostic and follow-up challenges due to subtle radiographic findings.
• Bronchoscopy is crucial for diagnosing and monitoring EBTB lesions during treatment.
• Chest CT and pulmonary function tests (PFTs) are valuable adjuncts in evaluating EBTB.

Purpose of the Study:

• To observe changes in EBTB lesions during treatment.
• To determine optimal timing and indications for follow-up bronchoscopy.
• To evaluate the utility of chest CT and PFTs in managing EBTB.

Main Methods:

• Eighty-one biopsy-proven EBTB patients were classified into seven subtypes based on bronchoscopic features.
• Prospective evaluation of bronchoscopic findings during treatment, with monthly follow-up bronchoscopies.
• Chest CT and PFTs were performed at initial bronchoscopy for a subset of patients.

Main Results:

• Most EBTB subtypes showed changes or resolution within 3 months of treatment.
• Actively caseating and oedematous-hyperaemic types often progressed to fibrostenotic.
• Tumorous EBTB exhibited complex evolution, with potential for later stenosis; chest CT measured bronchial involvement and stricture; PFTs indicated a restrictive pattern.

Conclusions:

• Follow-up bronchoscopy within 3 months predicts therapeutic outcomes for most EBTB subtypes, excluding the tumorous type.
• Tumorous EBTB requires careful monitoring due to complicated lesion evolution and potential for late stenosis.
• Chest CT and PFTs are useful tools for assessing bronchial involvement, stricture, and aiding in the differential diagnosis and follow-up of EBTB.