Delclaux B, Rabut H, Janvoie B, Nikoyagize E, Varaigne F, Lavandier M
Service de Pneumologie, CHU Bretonneau, Tours.
Rev Pneumol Clin. 1990;46(3):103-8.
Nowadays, bronchial tuberculosis is an uncommon, although probably underestimated, form of tuberculosis. The records of 23 patients hospitalized between 1978 and 1989 were reviewed retrospectively. Mean age was 57 years (range: 22 to 84 years). Only one female patient of african origin was a recent immigrant. The disease was pseudo-tumoral in 2 cases and included lymph node fistulae in 4 cases. M. tuberculosis was found at microscopic examination in only 10 patients. The course of the disease was slow and sometimes erratic, even under a well-conducted medical treatment. In one of the female patients, a lymph node fistula appeared after 6 months of chemotherapy, and it is clear that medical treatment must be pursued well beyond the conventional time limits. Several mechanisms are responsible for bronchial tuberculosis: either invasion of the neighbouring bronchi by pulmonary tuberculosis; or lymph node fistula now more frequently due to reactivation of old lesions than to a recent primary infection; or again primary bronchial lesions mimicking bronchial carcinoma.
如今,支气管结核是一种虽不常见但可能被低估的结核病形式。对1978年至1989年间住院的23例患者的记录进行了回顾性研究。平均年龄为57岁(范围:22至84岁)。仅有1例非洲裔女性患者是近期移民。2例表现为假瘤样病变,4例伴有淋巴结瘘。仅10例患者在显微镜检查中发现结核分枝杆菌。即使在规范的药物治疗下,疾病进程仍较为缓慢,有时还不稳定。其中1例女性患者在化疗6个月后出现淋巴结瘘,显然药物治疗必须远超常规时限。支气管结核的发病机制有多种:要么是肺结核侵犯邻近支气管;要么是淋巴结瘘,如今更多是由于陈旧病灶重新激活而非近期原发性感染所致;要么是原发性支气管病变酷似支气管癌。