title: [Usefulness of bronchofiberscopy for the diagnosis of pulmonary non-tuberculous mycobacteriosis--an analysis mainly on pulmonary M. avium complex disease].
abstract: OBJECTIVE
  The aim of this study was to evaluate the usefulness of bronchofiberscopy (BFS) in the diagnosis of pulmonary non-tuberculous mycobacteriosis (PNTM).
  
  
  METHODS
  Among 909 PNTM patients admitted to our hospital during the period from 1995 to 2006, BFS was performed for the diagnosis of PNTM in 107 patients (12%) who had either a negative sputum-smear for acid-fast bacilli (AFB) (n = 100) or from whom it had been impossible to collect sputum (n =7). For these 107 cases, we retrospectively compared and analyzed the findings from specimens obtained by BFS, such as smears, cultures, polymerase-chain reaction (PCR), and transbronchial lung biopsy (TBLB), with clinical, radiological, and sputum examination disease, was also seen in the positive ratios of other nontuberculous mycobacteriosis cases. Type and/or spread of MAC disease on chest radiographs did not relate to positive ratios of BFS obtained specimens. Based on overall BFS findings, including the examination of sputum immediately after BFS, 68 of 92 (74%) patients met the diagnostic criteria of MAC disease. Furthermore, through a combination of positive-TBLB findings and positive-PCR findings of BFS specimens, we were able to obtain an early and strong indication of MAC disease in 17 of 36 (47%) patients.
  
  
  CONCLUSIONS
  Using BFS to obtain various kinds of specimens is a useful tool for the early and definite diagnosis of PNTM/pulmonary MAC disease.
authors.affiliation: Department of Respiratory Diseases, National Hospital Organization Tokyo National Hospital, Japan. tamura@tokyo.hosp.go.jp
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Tamura
authors.forename: Keiko
authors.initials: K
authors.lastname: Muraki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shimada
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Suzuki
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Kashizaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Matsui
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawashima
authors.forename: Junko
authors.initials: J
authors.lastname: Suzuki
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Ariga
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Ohshima
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Masuda
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Matsui
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nagai
authors.forename: Shinobu
authors.initials: S
authors.lastname: Akagawa
authors.forename: Naohiro
authors.initials: N
authors.lastname: Nagayama
authors.forename: Emiko
authors.initials: E
authors.lastname: Toyota
authors.forename: Kazuko
authors.initials: K
authors.lastname: Machida
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Kurashima
authors.forename: Yutsuki
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Hideki
authors.initials: H
authors.lastname: Yotsumoto
authors.forename: Akira
authors.initials: A
authors.lastname: Hebisawa
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000382:microbiology; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology