Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan.
Department of Pathology Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Japan.
Intern Med. 2021 Feb 1;60(3):445-448. doi: 10.2169/internalmedicine.4511-20. Epub 2020 Sep 19.
Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO.
粟粒性肺结核是一种潜在致命的肺结核类型，是由结核分枝杆菌经血行播散引起的。本文描述了一例 34 岁男性患者，他因咳嗽和发热就诊，痰涂片结果为阴性。胸部计算机断层扫描显示双侧小叶中心性磨玻璃样混浊（GGO），提示过敏性肺炎；因此进行了支气管镜检查。冷冻活检标本显示坏死性肉芽肿。支气管镜检查后的再次检查发现了结核分枝杆菌，诊断为粟粒性肺结核。冷冻活检对于粟粒性肺结核的病理诊断可能是有用的，特别是当磨玻璃样混浊可能掩盖粟粒性结节时。
