Gadiolet Y, Bayle J Y, Perol M, Guérin J C
Service de Pneumologie, Hôpital de la Craix Rousse, Lyon.
Rev Pneumol Clin. 1990;46(3):109-13.
Four cases of bronchial tuberculosis are reported. The first case was revealed by signs of bronchitis; in the second patient M. tuberculosis was found at light microscopy but x-ray films of the chest were normal; the third patient presented with signs of bronchitis and upper lobe infiltration on fibrous sequelae; the fourth patient showed a pseudo-tumoral bronchial image. These cases and those of the literature show that clinical signs are usually those of bronchitis sometimes with the systemic symptoms of tuberculosis. Chest radiography may be normal or may display disorders of ventilation of lung opacities suggestive of recent tuberculosis. Endoscopy reveals granular inflammation with whitish secretion and progressive stenosis. Diagnosis rests on bacteriological and pathological examinations. Medical treatment does not differ from the standard one. Sequelae consisting of bronchial stenosis or bronchiestasis are extremely frequent. Bronchial tuberculosis is now seldom encountered and usually affects elderly women. However, it may now become more frequent due to the greater number of cases of tuberculosis with a slightly atypical course, as found in AIDS patients.
报告了4例支气管结核病例。第一例由支气管炎症状发现;第二例患者在光学显微镜下发现结核分枝杆菌,但胸部X光片正常;第三例患者表现为支气管炎症状及上叶纤维性后遗症浸润;第四例患者显示出假性肿瘤性支气管影像。这些病例以及文献中的病例表明,临床症状通常为支气管炎症状,有时伴有结核病的全身症状。胸部X线检查可能正常,也可能显示提示近期结核病的肺不透明度通气障碍。内镜检查显示颗粒状炎症伴白色分泌物及进行性狭窄。诊断依赖于细菌学和病理学检查。药物治疗与标准治疗无异。支气管狭窄或支气管扩张形成的后遗症极为常见。支气管结核现在很少见,通常影响老年女性。然而,由于艾滋病患者中出现的结核病病例数量增加且病程略有非典型性,现在它可能会变得更加常见。