1994 Volume 16 Issue 6 Pages 582-586
We report a case of tracheobronchial tuberculosis, which was considered to be early exacerbation, during the treatment of mediastinal tuberculous lymphadenitis and describe the course of its endoscopical findings. A 28-year-old man was admitted to our hospital because of general malaise, fever, anterior chest pain and dry cough. A chest X-ray examination revealed a widened right paratracheal region and chest CT scans revealed mediastinal lymphadenopathy. After injection of contrast medium, swollen nodes showed multifocal small areas of low density, enhanced margin and multiple septa. The biopsy specimens of mediastinal nodes revealed caseating granulomas and contained small numbers of acid-fast bacilli. Culture of the lymph node later yielded M.tuberculosis. Mediastinal tuberculous lymphadenitis was diagnosed and treated by SM INH REP. However, the symptoms continued and after three months, bronchoscopic examination revealed three polyp-like lesions around the bifurcation and a similar lesion on the right tracheal wall. The pathological findings of the polyp-like lesion showed caseating granulomas and tracheobronchial tuberculosis was diagnosed. At ten months of treatment, polyp-like lesions had improved and anthracosis was found at the sites of perforation of tuberculous lymph nodes.
