Case Analysis Of 44 Endobronchial Tuberculosis Diagnosed By Fiberoptic Bronchoscopy

Objective:To explore the clinical case characteristic and diagnostic value of FOB for endobronchial tuberculosis.Materials and Method:44 EBTB inpatients diagnosed by FOB for pathology in our Respiration department between January 2005 and January 2009 were analyzed retrospectively,The age,gender,main symptom of 44 EBTB were Summarized.To analyze the admission diagnosis,which disease can be misdiagnosed easily and summarize respective characteristic,the reason of misdiagnosis.To analyze the manifestation of HRCT and FOB,especially summarize the characteristic of onset location and type under FOB.Result:There were 29 females and 15 males in 44 cases,with a mean age of 44.36±18.51.we divided them into three groups.There were 15 females between 15-44 years old,6 between 45-59 years old,5 in 60-74,2 in 75 and above.There were 8 males between 15-44 years old,4 between 45-59 years old, 1 in 60-74,2 in 75 and above.The pathogenesis is from 15d to 2y,with a mean pathogenesis of 157.38±131.38d.During 44 EBTB,18 of which were misdiagnosed for pneumonia,5 for COPD,2 for Asthma,10 for central lung cancer,1 for acute tracheobronchitis,2 for pulmonary tuberculosis,6 of which were firstly found atelectasis through imaging examination.The main symptom were cough 37(84.1%),expectoration 29(65.9%),wheezling13(29.5%),fever13 (29.5%),hemoptysis6(13.6%),chest pain7(15.9%),one(2.3%) was asymptomatic,only be found when he had health examination.During 44 EBTB,10 of them were firstly considered as central lung cancer, Three had tube obliteration,around by soft tissue shadow;Three had big hilar shadow,atelectasis of right middle lobe,lymphadenopathy;Two had atelectasis of left upper lobar,tube wall tickening,obliteration;Two were space occupying. 2 of 44 EBTB which were misdiagnosed as asthma initially only displayed spot flake shadow and mediastinal lymphadenectasis.16 were luminal stenosis,11 were tube wall thickening,3 were obliteration.There are 25 atelectasis.10 of 44 EBTB were complicated with lung tuberculosis.There were 67 focus of infection in all under FOB.17 of them have two trachea affection.Unilateral site and single position 27,unilateral site and more than one position 10,bilateral site and more than one position 3,4 were involved in main bronchus The distribution is as follows:main bronchus in 8, left main bronchus in11,left upper lobar bronchus in 10,left lower lobar bronchus in 9,right main bronchus in 8,right upper lobar bronchus in 6, right-middle lobar bronchus in 8,right-lower lobar bronchus in7.Most common manifestation under the bronchoscope is edematous-hyperemic in 25(56.8%), followed by fiber stenosis in 5(27.3%),granular proliferation in 12(11.4%), alcerative2(4.5%).Conclusion:EBTB occurs mainly in young female.Cough and expectation are the most common complains,EBTB has longer pathogenesis. EBTB often shows luminal stenosis,tube wall thickening and atelectasis or not under HRCT.EBTB is often complicated with pulmonary tuberculosis.The onset location of EBTB has nothing to do with left and right,upper,middle, lower lobar bronchus,mostly in unilateral site and single position Edematous-hyperemic is the most common type under FOB.The patients who have long-term cough and wheelzing repeatedly,bad therapeutic efficacy and atelecatasis should take FOB as conventional examination.It is very necessary to use fibrobronchoscope for final diagnosis.