Related Experiment Video

Updated: Feb 18, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Published on: June 16, 2020

Tuberculosis presenting as isolated bronchonodal fistula in a patient with systemic lupus erythematosus: Case report

Kyungsoo Bae¹, Kyung Nyeo Jeon, Ho Cheol Kim

¹Department of Radiology Department of Internal Medicine Department of Pathology, Gyeongsang National University School of Medicine, Institute of Health Sciences, Jinju, Gyeongsang National University Changwon Hospital, Changwon, Korea.

|November 16, 2017

Abstract

Rationale:

Lymph node is a preferred site for extrapulmonary tuberculosis (TB). In the thorax, mediastinal tuberculous lymph nodes can erode adjacent structures such as heart, aorta, and esophagus, forming fistula, and causing fatal consequences. However, tuberculous bronchonodal fistula as a complication of lymph node TB in adults is rarely known in terms of imaging or clinical findings. Here, a case of isolated tuberculous bronchonodal fistula appearing as the first presentation of TB in a 74-year-old male with systemic lupus erythematosus (SLE) is reported.

Patient Concern:

A 74-year-old male with SLE visited the hospital with dry cough. In family history, his son was treated for pulmonary TB 9 years previously. Laboratory test revealed increased C-reactive protein level and erythrocyte sedimentation rate. Chest computed tomography (CT) scan revealed a necrotic lymph node in the right hilar area connected to the inferior wall of the right upper lobe bronchus and the lateral wall of bronchus intermedius.

Diagnoses:

On bronchoscopy performed under guidance of 3-dimensionally reconstructed CT image, fistula formation between the right hilar lymph node and 2 bronchi (the right upper lobe and intermediate bronchus) was confirmed. Sputum culture revealed growth of Mycobacterium tuberculosis.

Intervention:

Anti-TB medication with isoniazid, ethambutol, pyrazinamide, and moxifloxacin for 9 months.

Outcome:

The patient's symptom was gradually improved. Follow-up bronchoscopy performed at 3 months after starting the medication revealed decreased size of the fistula.

Lessons:

This is a rare case of bronchonodal fistula appearing as the first presentation of TB in a 74-year-old male patient with SLE. CT provided useful information regarding the origin and progress of the disease.

More Related Videos

Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation

Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation

Published on: July 10, 2012

Related Concept Videos

Pulmonary Tuberculosis II

Pulmonary Tuberculosis II

Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...

Pulmonary Tuberculosis I

Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...

Pulmonary Tuberculosis III

Pulmonary Tuberculosis III

Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:

Pulmonary Tuberculosis V

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...

Pulmonary Tuberculosis IV

Pulmonary Tuberculosis IV

Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...

Other Pulmonary Disorders

Other Pulmonary Disorders

Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.

Articles linked to this work by shared authors, journal, and citation graph.

Individually Prescribed In-Bed Exergaming Using Nintendo Ring Fit Adventure in Posttransplant Inpatients With Marked Functional Impairment After Intensive Care: Prospective Single-Arm Feasibility Study.

JMIR serious games·2026

Longitudinal recovery of physical function after lung transplantation: a comparative analysis of ECMO and non-ECMO recipients.

BMC pulmonary medicine·2026

Complete remission of minimal change disease after antiviral monotherapy in a patient with immune-active chronic hepatitis B: A case report.

Medicine·2026

Clinical Characteristics and Outcomes of Anti-MDA5 Antibody-Associated Interstitial Lung Disease: A Single-Center Retrospective Cohort Study from an Integrated Advanced Lung Disease and Lung Transplant Program in the US.

Journal of clinical medicine·2026

Quantitative Chest CT-derived Fibrosis and Vascular Remodeling and Acute Exacerbation Risk in Mild Idiopathic Pulmonary Fibrosis.

Radiology·2026

Extent of Endobronchial Ultrasound Nodal Sampling and Risk of Pathologic N2 Upstaging in Clinical N0-N1 Non-Small Cell Lung Cancer.

Thoracic cancer·2026

See all related articles