Endobronchial tuberculosis

Endobronchial tuberculosis (EBTB) is defined as tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence. It is seen in 10-40% of patients with active pulmonary tuberculosis. More than 90% of the patients with EBTB have some degree of bronchial stenosis. Ten to 20 percent have normal chest radiograph. Therefore, a clear chest radiograph does not exclude the diagnosis of EBTB. Bronchoscopic sampling has been the key to the diagnosis producing more than 90% yield on smear as well as on culture. Bronchoscopy and computed tomography are the methods of choice for accurate diagnosis of bronchial involvement and assessment for the surgical interventions. Characteristic HRCT findings of FBTB are patchy asymmetric centrilobular nodules and branching lines (tree-in-bud appearance). Early supervised antituberculosis therapy results in minimal structural and functional residua. Corticosteroid therapy may not influence the outcome of endobronchial tuberculosis. Early diagnosis and prompt treatment, before the development of fibrosis is important to prevent complications of endobronchial tuberculosis, such as bronchostenosis.