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KMID : 0390320130230010193
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Chungbuk Medical Journal
2013 Volume.23 No. 1 p.193 ~ p.200
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Trachea and Endobronchial Tuberculosis: Comparative Analysis of Clinical, Radiological and Bronchoscopic Characteristics
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Lee Kee-Man
Choe Kang-Hyeon
Ahn Jin-Young
Jeong Hye-Won
Lee Ok-Jun
Kim Sung-Jin
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Abstract
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Purporse : The purpose of our study is to find pathogenesis of endobronchial tuberculosis through analysis between the characteristics of endobronchial tuberculosis and combined pulmonary tuberculosis in adult patients. Materials and Methods : Through the electronic medical records of patients who were performed bronchofibroscoy at Chungbuk National University Hospital from January 2011 to February 2013. 44 patients with endobronchial tuberculosis were enrolled in our study. We analyzed the characteristics of bronchoscopic, microbiologic and radiographic findings between endobronchial tuberculosis with caseous necrotic mucus(Group I) and severe bronchial stenotic type(Group II). Results : The mean age of enrolled patients was 62 years old and female patients were more frequent than male patients(73% vs. 27%). Active caseating and edematous-hyperemic type were common(34.1% each other) in bronchoscopic findings. Right upper lobe endobronchial tuberculosis was most common(29.5%) but right middle lobe and left lower lobe bronchus were common site also( 34.1%) among involved bronchus. Most common lung parenchymal lesion was patchy consolidation type(44.2%). Central necrosis of lymphadenopathy on adjacent to endobronchial tuberculosis were rare(3 cases). The patients of group II showed tendency of less frequent M. tuberculosis culture positivity than that of Group I(p=0.06) and more frequently severe lobar consolidation at the distal site of endobronchial tuberculosis than that of group I(p<0.05). Conclusion : The pathogenesis of endobronchial tuberculosis in adult suggest that persistent mucosal implantation of M. tuberculosis cause endobronchial tuberculosis and severe bronchial stenosis can cause severe lobar consolidation by retained caseous necrotic mucus at the distal lesion.
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KEYWORD
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Lung, Tuberculosis, endobronchial, pathogenesis
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