Abstract:

Objective This study aimed to investigate the clinicopathologic features and pathogenic detection value of tracheobronchial tuberculosis (TBTB).Methods Totally, 164 patients with TBTB were enrolled in Shaanxi Provincial Tuberculosis Control Hospital from January to December 2017. The general information, CT scan image, tissue biopsy, sputum test, MTB culture and GeneXpert MTB/RIF (GeneXpert) detection results were collected. Then the clinical and CT imaging features, the type of lesions under bronchoscopy, histopathological features, and pathogenic detection results of TBTB patients were analyzed.Results Among 164 subjects, 153 (93.29%) had cough and 108 (65.85%) had fever; and the lesions of 109 cases (66.46%) were predominantly on the right side. CT scan mainly showed irregular lumen stenosis in 92 cases (56.10%), irregular wall thickening in 45 cases (27.44%), and hilar or near-lung soft tissue shadow in 27 cases (16.46%). Bronchoscopy mainly exhibited inflammatory infiltration (69 cases (42.07%)), ulcer necrosis (46 cases (28.05%)), and granulation proliferation (29 cases (17.68%)). Histopathological changes showed 46 cases of exudative lesions (28.05%), 32 cases of proliferative lesions (19.51%), 36 cases of necrotic lesions (21.95%), and 50 cases of complex lesions (30.49%). Eighty-five subjects all underwent acid-fast staining in tissue and sputum, MTB culture and GeneXpert test. The positive rate of acid-fast staining+GeneXpert+MTB culture was 57.65% (49/85), which was significantly higher than that of acid-fast staining (37.65% (32/85)), with a significant statistical difference (χ ²=6.82, P=0.009).Conclusion TBTB patients exhibit diverse bronchoscopy and pathological features, and the positive rates of different pathogenic detection methods are quite different. These results indicated that TBTB should be diagnosed based on the comprehensive analysis, including clinicopathologic features, CT imaging and various pathogenic detection results.

Key words: Tuberculosis, Bronchial, Pathological conditions, signs and symptoms, Diagnostic techniques and methods