Yasemin SAYGIDEĞER, Sadık ARDIÇ, Özlem SEVER, Burcu OKTAY, Emine SEVGİ, Hikmet FIRAT

Bilateral multiple tumor-like endobronchial tuberculosis, diagnosed with bronchoscopic examination

Endobronşiyal tüberküloz (EBTB), trakeobronşiyal ağacın tüberküloz ile infeksiyonu olarak tanımlanır ve erişkin popülasyonda sık rastlanmayan bir durumdur. Parankimal hastalık görülmediğinde EBTB daha az fark edilmekte ve tanıda zorluklara neden olmaktadır. Amacımız, az görülen ve seyri sırasında bronkostenoz gelişebilmesi açısından önemli olan bu hastalıkla ilgili bir olguyu sunmaktır. Olgudaki, 20 yaşındaki kadın hasta iki aydır nonprodüktif öksürük, nefes darlığı ve son dönemde minimal hemoptizi ile başvurmuştur. Klinik ve radyolojik değerlendirme sonrasında fleksibl bronkoskopi ile ana karinadan itibaren her iki ana bronşta çok sayıda tümör görünümlü endobronşiyal lezyon izlenmiştir. Biyopsi sonrası tanı EBTB gelmiş ve antitüberküloz tedavinin ikinci ayında endobronşiyal lezyonlar kaybolmuştur. Hasta stenoz gelişmeden iyileşmiştir. Bu olgu, endobronşiyal lezyonların ayırıcı tanısında EBTB’nin de akla gelmesi gerekliliğini hatırlatmaktadır. EBTB olgularının komplikasyonsuz iyileşebilmesi zamanında tanı ve tedavi başlanması ile olanaklıdır.

Bronkoskopik inceleme ile tanı alan endobronşiyal tüberküloz olgusu

Endobronchial tuberculosis is defined as tuberculosis infection of tracheobronchial tree and it is not seen often in adult population. In the absence of parenchymal disease endobronchial tuberculosis is less well-recognized and can lead to difficulties in diagnosis. Our aim is to introduce a rare form of tuberculosis that is important because of high probability of developing severe bronchostenosis during its course. We report a 20-year-old woman who presented with two-month history of severe non-productive cough, shortness of breath, and hemoptysis. After clinical and radiological evaluation, flexible bronchoscopy showed bilateral multiple tumorous lesions that were seen from main carina down to the both main bronchus. The biopsy samples revealed EBTB diagnosis and antituberculosis therapy was given. At the second month of the therapy, rebronchoscopy revealed almost disappearance of the polypoid lesions. The patient healed without any stenosis. This case report is a reminder that endobronchial tuberculosis must take into consideration in differential diagnosis of endobronchial lesions. In patients with endobronchial tuberculosis healing without any complication could be achieved with timely diagnosis and commencement of early treatment.

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