الجامعة السورية الخاصة

أهم ما يجب معرفته عن السل داخل القصبات

Authors

Yousser Mohammad

Published in
Ec Pulmonologyand Respiratory Medicine

Abstract
Endobronchial tubercuLosis (EBTB) or tracheobronchiaL tuberculosпs is a speciaL form oftuberculosпs (TB) and пs defined as tubercuLosis infection ofthe tracheobronchial tree, with or without parenchymaL invoLvement, with microbiaL and/or histopathoLogical evidence
Pathology
• Infection ofthe bronchi couLd be secondary to direct extension from an adjacent parenchymaL lesion, or lymph node erosion into the bronchi. Or could be autonomk by aspпration of TB, or by hematologk dissemпnatпon.
• Then histopathoLogпcaL evidence of epfthelпogigantocelluLar granuloma in bпopsy of the пntrabronchial Lesпon, could be foLLowed by fibrostenotic sequeLLa, especialLy if neglected [1-3].
Diagnosis ofEBTB
Clinical manifestations: Somefimes symptoms of TB are present: anorexпa, weight Loss, Cough, hemoptysis, low temperature. Other Urnes there is onLy Localized wheezing when stenosis ofthe bronchi and in this case, it could misLead for asthma or foreign body [6]. Other times, in smokers it couLd be cough, weпght loss and non-fever mimic cancer [5].
Chest XR: Chest XR could be normaL in 10% - 20% of cases. In other cases, it could be mпsleadпng for cancer Fortunately, пn many cases it shows typicaL infiltration of upper parts ofthe Lungs. Cavitation, mediastinal adenopathy’s, especiaLly in chiLdren, or pleuraL effusion. suggesting tuberculosпs [2,3,5].
Tuberculosis bacilli in the sputum; kid —fast baciLli staining (AFB] in expectoration is rarely positive confirming the presence of tubercuLosпs baciLLi (10 - 30%). New nuclear amplification test: Expert MDR/RIF is promпsпng пn case of negatпve MB [3,5].
Bronchoscopy is the most valuable test for diagnosis; Bronchoscopic appearances of EBTB have been divided into seven subtypes:
acfively caseating, edematous-hyperemпc, fibrostenotic, tumorous, granular, ulceratпve, and nonspecпfic bronchftпs [3]. See figure 1 and 2 showing tumor aspect [5].

Keywords:
Endobronchial;Tuberculosis; EBTB

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