Endobronchial Involvement in Tuberculosis

Abstract

Endobronchial tuberculosis was diagnosed in 24 patients in whom bronchoscopy was performed on suspicion of bronchogenic carcinoma (22 patients) or for evaluation of probable lung metastasis and hemoptysis (1 patient each). Bronchial wall edema was the most common abnormality seen on bronchoscopy (17 patients, 70.8%); infiltrating, nodular, and mass lesions were also observed. Three patients (12.5%) had left vocal cord paresis. The right bronchial tree was involved in two thirds of the patients. Endobronchial disease was located more commonly in the upper and lower lobar bronchi (9 patients each, 37.5%): the right middle lobar bronchus was also frequently involved (7 patients, 29.2%). Mycobacteria were demonstrated on smear examination and/or culture in 4 of 8 (50.0%) bronchial wash specimens and in 5 (20.8%) bronchial biopsy specimens. A high index of suspicion is essential to diagnose endobronchial tuberculosis in high-prevalence countries. Flexible bronchoscopic examination is important in all such patients in whom the diagnosis is not established on sputum analysis.