Kemal BAKIR, Ayten FİLİZ, Öner DİKENSOY, Meral UYAR, Ahmet METE, Deniz ÖZÇALIŞKAN

Endobronchial tuberculosis mimicking lymphoma

Endobronşial tuberküloz farklı klinik tablolarda karşımıza çıkabilir. Biz bu yazıda öksürük şikayeti olan 55 yaşındaki bir kadın hastayı sunduk. Hastanın palpe edilebilen supraklaviküler ve servikal lenf nodları mevcuttu. Toraks BT’de multipl konglomere mediastinal lenf nodları mevcuttu. Fiberoptik bronkoskopik incelemede ise yaygın mukozadan kabarık mukozal nodülariteler her iki akciğer alanlarında tespit edildi. Bronş lavajı ARB’si negatif olmasına rağmen endobronşial alandan alınan biyopsiler tüberküloza uyan şekilde kazeöz granulomatöz inflamasyonla uyumluydu. Tüberküloz tedavisi başlandıktan bir ay sonra düzelme tespit edildi. Bu olgu sunumu özellikle tüberküloz insidansının yüksek olduğu populasyonlarda multipl mediastinal lenfadenopatilerin ayırıcı tanısında fiberoptik bronkoskopinin önemini göstermektedir.

Lenfomayı taklit eden endobronşial tüberküloz

Endobronchial tuberculosis may present with different clinical pictures. We presented a 55 year old patient with complaint of cough. She had palpable supraclavicular and cervical lymph nodes. Thorax CT revealed multiple conglomerated mediastinal lymph nodes. Multiple swollen mucosal nodularities were observed on bilateral endobronchial area during fiberoptic bronchoscopy. Although acidfast bacilli were negative in bronchial lavage fluid, biopsies obtained from the endobronchial nodules revealed caseous granulomatous inflammation compatible with tuberculosis. Improvement was achieved one month following antituberculosis therapy. This case report shows the importance of fiberoptic bronchoscopy in the differential diagnosis of subjects present with multiple mediastinal lymphadenopathies especially in populations where incidence of tuberculosis is high.

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