Endobronchial tuberculosis: histopathological subsets and microbiological results
Sevket Ozkaya1, Salih Bilgin, Serhat Findik
1Rize University, Faculty of Medicine, Department of Pulmonary Medicine, Rize, Turkey. ozkayasevket@yahoo.com.
Multidisciplinary Respiratory Medicine
|October 24, 2012
Summary
Endobronchial tuberculosis (EBTB) diagnosis is aided by bronchoscopy. The granular subtype showed the highest microbiological positivity in bronchial lavage fluid, suggesting its utility in diagnosing EBTB.
Area of Science:
- Pulmonology
- Infectious Diseases
- Microbiology
Background:
- Endobronchial tuberculosis (EBTB) involves tuberculous infection of the tracheobronchial tree.
- Seven bronchoscopic subtypes exist: actively caseating, edematous-hyperemic, fibrostenotic, tumorous, granular, ulcerative, and nonspecific bronchitic.
- Microbiological diagnosis for each subtype remains challenging.
Purpose of the Study:
- To document the prevalence of EBTB bronchoscopic subtypes.
- To correlate bronchoscopic findings with microbiological results from bronchial lavage fluid.
Main Methods:
- A study of 23 biopsy-proven EBTB patients from 2003 to 2009.
- Histopathological confirmation of EBTB in all participants.
- Analysis of bronchoscopic appearances and microbiological data (AFB smear, M. tuberculosis culture) from bronchial lavage.
Main Results:
- Edematous-hyperemic (34.7%) was the most common EBTB subtype, followed by tumorous (21.7%) and granular (17.3%).
- While sputum was smear-negative, 26% of bronchial lavage samples were AFB smear-positive, and 39.1% yielded Mycobacterium tuberculosis culture.
- The granular subtype demonstrated the highest AFB smear (75%) and M. tuberculosis culture (75%) positivity in bronchial lavage.
Conclusions:
- The edematous-hyperemic subtype is most frequent in EBTB.
- Granular EBTB exhibits superior microbiological detection rates in bronchial lavage.
- Bronchoscopy is recommended for suspected EBTB cases.
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