[Two cases of elderly people diagnosed with acute tuberculous pneumonia possibly succeeded by the perforation of lymph nodes in the bronchus].

The report is a study of the cases in which elderly people (83 years-old male and 81 years-old female) diagnosed has having acute tuberculous pneumonia possibly suffered from subsequent perforation of lymph nodes in the bronchus. Neither of the patients had a prior history of tuberculosis treatment. Both patients were admitted to the hospital after being diagnosed with pneumonia. After the administration of antibiotics, the symptoms of illness improved, but chest roentgenograms were taken failed to show improvement. The patients were then transferred to our hospital, because sputa smear tests for Mycobacteria (Ziehl-Neelsen stain) were performed, and the results were positive. Case I (male) was suspected of having endobronchial tuberculosis, since rhonchi was audible in the left-front upper chest during expiration when performing auscultation. A bronchoscopy was conducted at which time ulcer lesions on the left upper lobe of the bronchus and perforated lymph node of the upper bronchus were detected. Case II (female) was suspected of having lung cancer and a bronchoscopy was performed due to the findings of a chest roentgenogram taken after one month of chemotherapy. A perforated lymph node in right truncus intermedius was detected. In this report, we discussed the early diagnosis of tuberculous pneumonia and the perforation of caseous lymph nodes in the bronchus, which was the main cause of tuberculous pneumonia.