BACKGROUND AND AIMS:
Tracheobronchial tuberculosis (TBTB) is a special form of pulmonary tuberculosis whose major feature is the infection of the tracheobronchial tree by Mycobacterium tuberculosis. TBTB is diagnosed on histopathological examination of bronchoscopically obtained specimens showing granulomatous inflammation with caseation necrosis and/or positive acid fast bacilli culture on the microbiological exam. Before bronchoscopy，TBTB is easily misdiagnosed as other lung diseases. This case presentation reports a patient with stable stage pulmonary tuberculosis patient is initially misdiagnosed as lung infection before bronchoscopy. Furthermore，sputum smears do not reveal acid-fast bacilli. After being bronchoscopied，the patient showed diffuse nodules in the tracheobronchial mucosa. Sputum culture by rapid liquid method shows positive Mycobacterium tuberculosis. This case can easily be missed diagnosis. It is necessary that bronchoscopy can be a routine means to screen TBTB among the patients with retreated pulmonary tuberculosis.
Report of one rare case.
Bronchoscopy showed the presence of diffuse miliary nodules in the mucosa of bilateral bronchi. Pathological examination revealed caseating necrotic granuloma. Mycobacterium tuberculosis was detected by rapid liquid culture. Our case was extremely difficult to diagnose the TBTB without abnormal chest X-ray or CT manifestations. By regular anti-tuberculosis treatment with 9 months course, the patient was finally cured with negative Mycobacterium tuberculosis and almost normal tracheobronchial mucosa.
bronchoscopy; chest CT; retreated pulmonary tubercilosis；tracheobronchial tuberculosis; diffuse nodules