Waseem Saeed, Jamal Ahmad, Arshad Naseem.
Endobronchial Tuberculosis: Clinical and diagnostic aspects.
Pak Armed Forces Med J Jan ;52(2):154-8.

This study was conducted at the Department of Pulmonology, Military Hospital Rawalpindi from Jan 1990 to Dec 2000 to determine common clinical features and diagnostic aspects especially bronchoscopic characteristics of endobronchial tuberculosis. A total of 180 consecutive cases of Endobronchial Tuberculosis of all ages and both sexes were included. The mean age was 29.82 (±4.32) years. Male to Female ratio was 2.4:1. Cough was the most common symptom (90.59%) with expectoration in 50.55% patients. Fever and hemoptysis were noted in 83 and 67 cases respectively. History of weight loss was present in 20.55% patients while chest pain and exertional dyspnea were noted in 17.77% and 13.33% cases respectively. Chest X-rays were normal in 77.77% cases. Endobronchial lesions on bronchoscopy were noted in upper lobes in 59.74% cases while lower lobe lesions were seen in 40 (25.97%) cases and 22 (14.28%) patients had involvement of right middle lobe or major bronchi. Endobronchial secretions yield for AFB positivity was cent percent and commonest histopathological feature was non caseating granuloma. Endobronchial tuberculosis is not an uncommon entity but due to non specific symptomatology and normal chest X-ray, a high index of clinical suspicion is required for timely diagnosis and appropriate management. Fiberoptic bronchoscopy with biopsy and bronchial washings is the investigation of choice.

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