Yamamoto Jun, Shimanouchi Masaoki, Hashizume Toshinori, Suito Tetsushi
Department of Thoracic Surgery, National Hospital Organization, Ibarakihigashi National Hospital, Ibaraki, Japan.
Kyobu Geka. 2015 Sep;68(10):836-9.
A 37-year-old woman was re-admitted to our hospital because the recurrence of endobronchial tuberclosis was suspected. Mycobacterium tuberculosis was not detected by culture of sputum and gastric fluid, and computed tomography revealed a left superior segmental bronchus obstruction and pneumonia. Her pneumonia improved by administration of antibiotics, but the strong cough persisted. Bronchoscopic examination revealed that the left superior segmental bronchus was blind. Mycobacterium tuberculosis was not detected from a biopsy of the blind bronchus wall. We diagnosed that her obstructive pneumonia was due to acquired atresia after endobronchial tuberculosis. Because a persistent cough even after the treatment of pneumonia indicated the possibility of recurrent obstructive pneumonia, surgical resection was performed. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. The atresia of the superior segmental bronchus was histologically considered to be acquired atresia due to the inflammation from tuberculosis.
一名37岁女性因怀疑支气管内膜结核复发再次入院。痰和胃液培养未检测到结核分枝杆菌,计算机断层扫描显示左上叶段支气管阻塞及肺炎。给予抗生素治疗后肺炎有所改善,但剧烈咳嗽仍持续。支气管镜检查发现左上叶段支气管闭塞。闭塞支气管壁活检未检测到结核分枝杆菌。我们诊断她的阻塞性肺炎是支气管内膜结核后获得性闭锁所致。由于肺炎治疗后持续咳嗽提示有复发性阻塞性肺炎的可能,遂行手术切除。术后病程顺利,患者于术后第8天出院。组织学上认为段支气管的闭锁是由结核炎症引起的获得性闭锁。