Achi V H, N'Dhatz M, Coulibaly G, Domoua K, Yapi A
Service Pneumophtisiologie, CHU de Bouaké, 01 BP 1174 Bouaké 01, Côte d'Ivoire.
Rev Pneumol Clin. 2002 Nov;58(5 Pt 1):277-81.
The aim of this retrospective study was to evaluate the yield of bronchial endoscopy for the diagnosis of tuberculous mediastinal adenopathies. We analyzed the results in 200 procedures in patients with tuberculous mediastinal adenopathies. Mediastinal tuberculous adenopathies were found in 6% of the patients with tuberculosis diagnosed during the same period. Mean age of the patients was 30.5 years, and the sex ratio was 1.5. Bronchial endoscopy improved the diagnostic yield of the bronchial aspiration fluid (22% versus 11% without endoscopy). This method allowed positive diagnosis of tuberculosis in 164 patients (82%) by visualizing specific lesions such as compressions, granulations, and gangliobronchial fistulae. Histological confirmation was obtained in 72 (79%) patients among 91 biopsy specimens. Bronchial endoscopy remains a crucial exploration for the diagnosis of mediastinal tuberculous adenopathy, even in HIV-infected patients, because in our series, among 101 treated patients, 99 were HIV positive (98%).
这项回顾性研究的目的是评估支气管内镜检查对结核性纵隔淋巴结病的诊断价值。我们分析了200例结核性纵隔淋巴结病患者的检查结果。在同期诊断为结核病的患者中，6%发现有纵隔结核性淋巴结病。患者的平均年龄为30.5岁，性别比为1.5。支气管内镜检查提高了支气管抽吸液的诊断阳性率（22%对比未行内镜检查时的11%）。通过观察压迫、肉芽组织和神经节支气管瘘等特异性病变，该方法使164例患者（82%）确诊为结核病。91份活检标本中有72例（79%）患者获得了组织学确诊。支气管内镜检查仍然是诊断纵隔结核性淋巴结病的关键检查手段，即使在HIV感染患者中也是如此，因为在我们的研究系列中，101例接受治疗的患者中有99例HIV阳性（98%）。
