LI Ping,YAN Sunshun,WU Liqin, et al. Clinical analysis of tracheobronchial tuberculosis with bronchoscopic performance looked like lung cancer[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(7): 521-.
Abstract：Objective: To improve the diagnosis and avoid misdiagnosis of tracheobronchial tuberculosis which bronchoscopic performance looked like lung cancer. Methods: The clinical data of 10 cases tracheobronchial tuberculosis which bronchoscopic performance looked like lung cancer from the Second Affiliated Hospital of Wenzhou Medical University during October 2011 to October 2012 were collected, and the possible causes of misdiagnosis of lung cancer were analysed. Results: Tracheobronchial tuberculosis often occured in middle-aged (90%, 9/10). Main clinical symptoms were cough, sputum and haemoptysis. Sputum-positive rate was low. Lesions locus of TBTB was mostly common on left upper lobar bronchus and right upper lobar bronchus (50%, 7/14). The rate of missed diagnosis and misdiagnosis were 50%. Bronchoscopy performance was neoplasm, which surface had some necrosis. Neoplasm could look like cauliflower, nodular or circular. Bronchus near the neoplasm often had stenosis, and was similar to bronchoscopic performance of primary lung cancer. So it made difficult to identify TBTB and primary lung cancer. There were 7 patients whose brush biopsy for acid-fast bacilli was positive (7/10). There were 7 patients whose brush pathology was positive (7/10). There were 4 patients whose biopsy pathology was positive (4/7). Three patients were positive in pathology of brush and biopsy. Three patients were positive in brush biopsy for acid-fast bacilli and biopsy pathology. Two patients were positive in pathology of brush and biopsy, and brush biopsy for acid-fast bacilli. Conclusion: Tracheobronchial tuberculosis is lack of specific clinical manifestations. When bronchoscopic performance can not be made a diagnosis of tracheobronchial tuberculosis or lung cancer, diagnose relys on bacteriology and biopsy pathology.
