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Abstract
Bronchial invasion of tuberculous lymphadenitis in children has been reported in areas of high tuberculosis (TB) prevalence as a complication due to primary pulmonary tuberculosis. However, it is rare in immunocompetent adults. When it appears, it often presents as a consequence of the reactivation of TB in the lung parenchyma. Primary TB occurs more frequently in patients with human immunodeficiency virus (HIV), with a history of organ transplants, or undergoing immunosuppressive treatments such as steroids. Furthermore, bronchial invasion of the bronchus by tuberculous lymphadenitis is considered to be very rare even among immunocompromised adults with primary TB, and has never before been reported in Korea. The authors report a case of bronchial invasion of the bronchus by tuberculous lymphadenitis, confirmed by bronchoscopy, in an Acquired Immunodeficiency Syndrome (AIDS) patient.
Figures and Tables
 | Figure 1Chest radiography shows mediastinal widening and right hilar bulging without parenchymal infiltration on admission.
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 | Figure 2Chest CT scan shows the enlargement of peribronchial lymph node in the right middle lobe bronchus.
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 | Figure 3Bronchoscopic findings: (A) Right middle lobe bronchus is filled with white caseous material, which is in agreement with the soft tissue abnormality seen on the chest CT. (B) A fistula was discovered after the removal of the white caseous material. (C) A fistula and white node-like spots are shown on the left main bronchus. These bronchoscopic findings suggested the infiltration of the TB lymphadenitis into the bronchus.
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 | Figure 4Histopathologic finding of bronchoscopic biopsy: (A) Caseous necrosis and lymphocyte infiltration (H&E stain, ×400). (B) Positive acid fast bacilli (AFB) are present (AFB stain, ×1,000).
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