[Clinical analysis of 90 cases with endobronchial tuberculosis].

OBJECTIVE

To explore the clinical features and early definite diagnosis of endobronchial tuberculosis(EBTB).

METHODS

Clinical symptoms, chest X-ray/CT manifestations and fiberoptic bronchoscopic findings of 90 cases with EBTB were analyzed.

RESULTS

Main symptoms were as follows: cough in 75 cases, fever in 27, haemoptysis in 24, pleural pain in 18, dyspnea in 11, weight loss in 7, etc. Signs of airway obstruction were rare, localized wheezing was found only in 2 cases. 7 cases in chest X-ray were normal, and only 2 cases in CT were indicative of EBTB. Bronchoscopic results showed exudative lesions in 38% of the cases, granulomatous lesions in 9%, cicatricial lesions in 26%, ulcerative lesions in 17%, and normal-like demonstrations in 11%. Positive results were found in 8 out of 50 by sputum acid-fast staining, 73 out of 86 by bronchoscopic brushing smears, and 17 out of 56 by bronchial biopsies.

CONCLUSIONS

The clinical features of EBTB are non-specific, and EBTB can not be excluded only by normal chest X-ray findings. In contrast to CT, bronchoscopy plays an important role in definite diagnosis of the disease. When patients with slight fever of unknown origin or respiratory symptoms do not respond to general treatment, EBTB should be suspected and early fibereoptic bronchoscopy be performed. Fiberoptic bronchoscopic brushing examination for acid-fast bacillus and bronchial biopsy are beneficial to rapid and definite diagnosis of EBTB.