Endobronchial tuberculosis polyps

Endobronchial tuberculosis (TB) is an uncommon manifestation of Mycobacterium tuberculosis. We report a case of endobronchial TB polyps in a patient from India presenting with cough, loss of weight and night sweats. Computed tomography chest revealed enlarged mediastinal lymph nodes, endobronchial i...

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Bibliographic Details
Published in:Respirology case reports 2020-08, Vol.8 (6), p.e00595-n/a
Main Authors: Yu, Christiaan, Foo, Chuan Tai, Aung, Ar Kar, Joosten, Simon A.
Format: Article
Language:English
Subjects:
Biopsy
Bronchoscopy
Case Report
Case Reports
Deoxyribonucleic acid
DNA
Endobronchial polyps
endobronchial tuberculosis
flexible bronchoscopy
Histopathology
Inflammation
Microscopy
Sarcoidosis
Tuberculosis
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Summary:Endobronchial tuberculosis (TB) is an uncommon manifestation of Mycobacterium tuberculosis. We report a case of endobronchial TB polyps in a patient from India presenting with cough, loss of weight and night sweats. Computed tomography chest revealed enlarged mediastinal lymph nodes, endobronchial invasion, and nodular infiltrates in the right lower lobe. Flexible bronchoscopy revealed two endobronchial polyps at the carina and left main bronchus which were biopsied. Histopathology showed non‐caseating granulomas. Both the biopsy and bronchial washings did not identify acid‐fast bacilli on Ziehl‐Neelsen stain and had negative TB complex DNA polymerase chain reaction. One month after bronchoscopy, M. tuberculosis was cultured from the bronchial washings. Following six months of TB treatment, there was full resolution of symptoms and significant radiological improvement. We highlight the diagnostic challenges in endobronchial TB which may impact on the timely institution of treatment. We present a patient with endobronchial tuberculosis (TB) polyps for which initial acid‐fast bacilli staining and TB complex DNA polymerase chain reaction yielded negative results. Histopathology showed non‐caseating granulomatous inflammation and the diagnosis was ultimately achieved four weeks later when bronchial washing cultures yielded Mycobacterium tuberculosis, thus highlighting the challenges in achieving a timely diagnosis.
ISSN:2051-3380
2051-3380
DOI:10.1002/rcr2.595