[Bronchial endoscopy for the diagnosis of tuberculous mediastinal adenopathies]

The aim of this retrospective study was to evaluate the yield of bronchial endoscopy for the diagnosis of tuberculous mediastinal adenopathies. We analyzed the results in 200 procedures in patients with tuberculous mediastinal adenopathies. Mediastinal tuberculous adenopathies were found in 6% of the patients with tuberculosis diagnosed during the same period. Mean age of the patients was 30.5 years, and the sex ratio was 1.5. Bronchial endoscopy improved the diagnostic yield of the bronchial aspiration fluid (22% versus 11% without endoscopy). This method allowed positive diagnosis of tuberculosis in 164 patients (82%) by visualizing specific lesions such as compressions, granulations, and gangliobronchial fistulae. Histological confirmation was obtained in 72 (79%) patients among 91 biopsy specimens. Bronchial endoscopy remains a crucial exploration for the diagnosis of mediastinal tuberculous adenopathy, even in HIV-infected patients, because in our series, among 101 treated patients, 99 were HIV positive (98%).