Gupta Prem Parkash, Verma Manish, Agarwal Dipti, Kumar Sanjay, Atreja Atulya
Department of Respiratory Medicine, Postgraduate Institute of Medical Sciences, University of Health Sciences, Rohtak, India.
Lung India. 2010 Oct;27(4):236-8. doi: 10.4103/0970-2113.71959.
Diffuse alveolar opacities (DAO) due to pulmonary tuberculosis are usually described in immunocompromised patients. In adult patients residing in high endemic areas such as India, alveolar opacities are not reported frequently in non-immunocompromised pulmonary tuberculosis patients. We describe a twenty-five-year-old woman who presented with bilateral diffuse alveolar opacities and initial diagnostic work up was directed to non-tuberculosis etiologies. Her sputum was not suggestive of tuberculous or any other infective etiology. However, histopathological examination of specimen from fine needle aspiration cytology through percutaneous route suggested chronic granulomatous disease with detection of mycobacterium. Polymerase chain reaction test in BAL and FNAC specimen confirmed tubercular etiology. Though not frequent, pulmonary tuberculous etiology is worth considering in the differential diagnosis of DAO as not only tuberculosis is fully treatable but also early detection shall help to avoid unnecessary invasive tests and cut down transmission to contacts.
因肺结核导致的弥漫性肺泡实变（DAO）通常见于免疫功能低下的患者。在居住于印度等高流行地区的成年患者中，非免疫功能低下的肺结核患者较少报告有肺泡实变。我们描述了一名25岁女性，她出现双侧弥漫性肺泡实变，初始诊断检查针对非结核病因。她的痰液未提示结核或任何其他感染性病因。然而，经皮细针穿刺细胞学标本的组织病理学检查提示为慢性肉芽肿病并检测到分枝杆菌。支气管肺泡灌洗（BAL）和细针穿刺抽吸活检（FNAC）标本的聚合酶链反应检测证实为结核病因。尽管不常见，但在DAO的鉴别诊断中，肺结核病因值得考虑，因为不仅结核病完全可治，而且早期检测有助于避免不必要的侵入性检查并减少向接触者的传播。
