Journal List > Tuberc Respir Dis > v.60(5) > 1000949

An, Lee, Park, Lee, Yang, Jung, Kim, and Kim: Clinical and Bronchoscopic Features in Endobronchial Tuberculosis

Abstract

Background :

The incidence of pulmonary tuberculosis has been reducing, but endobronchial tuberculosis continues to be a signigicant heath problem. We performed prospectively bronchoscopy in patients diagnosed with pulmonary tuberculosis in order to evaluate the frequency of endobronchial tuberculosis and its related findings. Follow-up bronchoscopy was also performed after treatment to evaluate the incidence of endobronchial complications such as stenosis and remaining lesions.

Methods :

From January, 1999 to December, 2003, bronchoscopy was performed on patients newly diagnosed with pulmonary tuberculosis.

Results :

458 patients were enrolled in this study, out of 699 patients with pulmonary tuberculosis from 1999 to 2003. 234(51%) had endobronchial tuberculosis. The frequency was 40.3% in males and 66.3% in females, The most common symptom was nonspecific cough and sputum, and the main radiologiy finding was patchy infiltration. The most common subtype of endobronchial tuberculosis was the edema-hyperemic form. The right lung was involved more frequently than the left, and the left upper lobe was the most commonly involved site. 58 patients underwent follow-up bronchoscopy and most of been cured without major sequels. However, 8 patients had a stenosis of trachea and main bronchus, and 6 patients had still had endobronchial lesions. Therefore the treatment was prolonged for 3 months.

Conclusion :

Endobronchial tuberculosis of pulmonary tuberculosis has been remained of high incidence. bronchoscopic and follow-up bronchoscopy examination needs to evaluate the incidence of endobronchial tuberculosis and its related findings and major complication despite of treatment.

REFERENCES

1.Williams DJ., York EL., Nobert EJ., Sproule BJ. Endobronchial tuberculosis presenting as asthma. Chest. 1988. 93:836–8.
crossref
2.Matthews JI., Matarese SL., Carpenter JL. Endobronchial tuberculosis simulating lung cancer. Chest. 1984. 86:642–4.
crossref
3.Chung HS., Han SK., Shim YS., Kim KY., Han YC., Kim WS, et al. Balloon dilatation of bronchial stenosis in endobronchial tuberculosis. Tuberc Respir Dis. 1991. 38:236–44.
4.Chung HS., Lee JH., Han SK., Shim YS., Kim KY., Han YC, et al. Classification of endobronchial tuberculosis by the bronchoscopic features. Tuberc Respir Dis. 1991. 38:108–15.
5.WHO. Global tuberculosis control: surveillance, planning, financing: WHO report. 2004.
6.Lew WJ. Tuberculosis surveillance system in Korea. Tuberc Respir Dis. 2000. 48:298–307.
crossref
7.Lee JH., Park SS., Lee DH., Shin DH Yang SC., Yoo BM. Endobronchial tuberculosis: clinical and bronchoscopic features in 121 cases. Chest. 1992. 102:990–4.
8.Kim SY., Suhr JW., Shin KS., Jeong SS., Park SG., Kim AK, et al. Endobronchial tuberculosis in patients with pulmonary tuberculosis. Tuberc Respir Dis. 1996. 43:138–46.
crossref
9.Park EJ., Kim MO., Yang SC., Sohn JW., Yoon HJ., Shin DH, et al. Clinical and bronchoscopic features of 280 patients with endobronchial tuberculosis: 1990-2001. Korean J Med. 2003. 64:284–92.
10.Ahn CM., Kim HJ., Hwang ES., Kim SK., Lee WY. A clinical study of 61 cases of tuberculous tracheobronchitis. Tuberc Respir Dis. 1991. 38:340–6.
11.Hirata S. Tracheobrochial tuberculosis observed from the chest X-ray findings and its pathogenesis. Kek-kaku. 1989. 64:319–27.
12.Jokinen K., Palva T., Nuutinen J. Bronchial findings in pulmonary tuberculosis. Clin Otolaryngol Allied Sci. 1977. 2:139–48.
crossref
13.Song JH., Han SK., Heo IM. Clinical study of endobronchial tuberculosis. Tuberc Respir Dis. 1985. 32:276–82.
crossref
14.Chung HS., Lee JH. Bronchoscopic assessment of the evolution of Endobronchial tuberculosis. Chest. 2000. 117:385–92.
crossref
15.Toppet M., Malfroot A., Derde MP., Toppet V., Spehl M., Dad I. Corticosteroid in primary tuberculosis with bronchial obstruction. Arch Dis Chil. 1990. 65:1222–6.
16.Chan HS., Pang JA. Effect of corticosteroid on deterioration of endobronchial tuberculosis during chemotherapy. Chest. 1989. 96:1195–6.

Figure 1.
Distribution of Involved sites.
trd-60-532f1.tif
Table 1
Patients enrollment
trd-60-532t1.tif
Table 2
: Age distribution of the cases
N. Of Endobronch ial TB Age
<20 20- 30- 40- 50- 60- >70
No 13 38 34 33 39 37 24
Yes 14 46 23 30 27 38 43
% 51.8 54.7 40.3 47.6 40.9 50.6 64.1
Table 3.
Clinical features of the cases
Clinical features N. of Endobronchial Tuberculosis(%)
Cough/Sputum 143/212(61.1)
Fever 48/129(20.5)
Hemoptysis 25/47(10.6)
Dyspnea 14/38(5.9)
Chest pain 4/32(1.9)
Table 4
Radiologic findings of the endobronchial tuberculosis patients
trd-60-532t4.tif
Table 5
Endobronchial tuberculosis classification by bronchoscopic features
trd-60-532t5.tif
Table 6
Follow-up bronchoscopic findings
trd-60-532t6.tif
TOOLS
Similar articles