title: Characteristics of endobronchial tuberculosis patients with negative sputum acid-fast bacillus.
abstract: OBJECTIVE
  Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. In this study, clinical, radiological and bronchoscopic characteristics of cases diagnosed to have EBTB were evaluated.
  
  
  METHODS
  Sixteen patients with at least three negative sputum examinations for acid-fast bacillus (AFB) and diagnosed as having EBTB on the histopathological examination of bronchoscopically obtained specimens showing granulomatous structures with caseation necrosis and/or positive AFB-culture on the microbiological examination of bronchoscopically obtained specimens were included in our study. Age, sex, symptoms, tuberculin skin test (TST), microbiological examination results and radiological findings were recorded. Bronchoscopical lesions were classified according to Chung classification.
  
  
  RESULTS
  EBTB was found to be more common in females. Most common symptoms were cough (100%), sputum (75%), weight loss (62.5%), hemoptisis (37.5%), chest pain (25%) and dyspnea (12.5%). Radiological examination findings revealed consolidations/infiltrations (87.5%), nodular lesions (37.5%), cavitary lesions (25%), unilateral (43.7%) or bilateral hilar widening (31.2%) and atelectasia (25%). Middle lob syndrome was seen in three cases. Most common lesions observed bronchoscopically were active caseous lesions, granular lesions, edematous hyperemic lesions, tumorous lesions, fibrostenotic lesions respectively. In all cases "granulomatous inflammation showing caseation" was shown in the histopathological examination of biopsy specimens.
  
  
  CONCLUSIONS
  EBTB can cause various radiological and bronchoscopical findings. In most of the cases distinct response is seen to antituberculous treatment. Bronchial stenosis is an important complication. Treatment should be given as soon as possible to avoid it.
authors.affiliation: Department of Pulmonology, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul 34760, Turkey.
authors.forename: Füsun
authors.initials: F
authors.lastname: Sahin
authors.affiliation: Department of Pulmonology, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul 34760, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Yıldız
keywords: Endobronchial tuberculosis (EBTB); bronchoscopy; histopathology; microbiology; radiology