Clinical characteristics of 92 misdiagnosis cases of tracheobronchial tuberculosis and the clinic value of endoscope / 天津医药

ABSTRACT

Objective To investigate the reasons of tracheobronchial tuberculosis misdiagnosis and its clinical charac?teristics as well as the diagnostic value of bronchoscope. Methods Clinical data of 92 cases of misdiagnosis of tracheobron?chial tuberculosis by electronic bronchoscopy in our department from January 2006 to January 2012 were analyzed retrospec?tively. Bronchoscopy, endoscopic biopsy, brushing, lavage and radiological images were all compared. Results Clinical symptoms and laboratory tests showed no specificity in diagnostic value;Chest X-ray was not typical. Bronchial stenosis was seen in 45 cases(48.9%)and bronchial obstruction was seen in 6 cases(6.5%)as shown in chest CT while no abnormality in the bronchus was seen in 41 cases(44.6%). Bronchoscopy revealed 28 cases (30.4%) of inflammatory infiltration, 14 cas?es (15.2%) of necrotizing ulceration, 35 cases (38.0%) of granulation hyperplasia and 15 cases (16.3%) of Scar stricture. En?doscopic biopsy confirmed 56 cases (60.9%), while bronchoscopic brushing and examination of acid-fast bacillus approved 32 cases (34.8%). Then, bronchoscopic lavage of acid-fast bacillus verified 39 cases (42.4%). Lastly, tuberculosis bacterium culture ascertained 75 cases (81.5%). Conclusion Bronchoscopy of local lesion with brush, lavage and biopsy is the most sensitive and specific diagnostic method to diagnose tracheobronchial tuberculosis. It has great clinical value in preventing tracheobronchial tuberculosis misdiagnosis.