SANTRAL BRONŞ TÜMÖRÜNÜ TAKLİT EDEN ENDOBRONŞİYAL TÜBERKÜLOZ OLGUSU

Öz

Endobronşiyal tüberküloz (EBTB), trakeobronşiyal ağacın mikrobiyolojik ve histopatolojik bulgularla kanıtlanmış tüberküloz infeksiyonu olarak tanımlanmaktadır ve akciğer tüberkülozunun ciddi komplikasyonlarından biridir. EBTB'lu olgular sıklıkla bronşiyal astım ya da akciğer kanseri gibi yanlış tanılar alabilmektedir. Elli yaşında bayan hasta pnömoni tanısı ile on günlük ampirik antibiyotik tedavisi ile kliniğinde herhangi bir düzelme olmaması üzerine çekilen Toraks BT'de sağ hiler bölgede kitle tespit edilmesi üzerine hastanemize sevk edildi. Hastaya yapılan bronkoskopide sağ akciğer üst lob girişinde mukozal infiltrasyon ve segment ayrımından önce endobronşiyal tümöral lezyon izlendi, buradan forceps biyopsi ve lavaj yapıldı. Lavaj sıvısında ARB (++) bulundu, biyopsi sonucu kazeifikasyon içeren granülomatöz proçes olarak değerlendirildi. Hastaya altı aylık standart anti-tüberküloz tedavi verildi. Tedavinin altıncı ayı sonunda çekilen Toraks BT'de sağ hiler bölgede izlenen kitle görünümünün tamamen kaybolduğu görüldü. Sonuç olarak burada, santral bronş tümörünü taklit eden ve anti-tüberküloz tedavi ile başarı ile tedavi edilen EBTB olgusu sunulmaktadır. Bu olgulara bronkoskopi ve bronkoskopik materyalde tüberküloz tanısına yönelik incelemelerin yapılması hem doğru tanının konulması hem de tedavinin erken başlanarak bronkostenoz gelişminin önlenmesi bakımından büyük önem taşımaktadır.

Anahtar Kelimeler

• Akciğer kanseri, Bilgisayarlı Tomografi, Bronkoskopi, Tüberküloz

A CASE: ENDOBRONCHIAL TUBERCULOSIS MIMICING CENTRAL BRONCHIAL TUMOR

Abstract

Endobronchial tuberculosis (EBTB) is defined as tuberculosis infection of the tracheobronchial tree proven by microbiologically and histopathologically findings and is one of the serious complications of pulmonary tuberculosis. Often, patients may be misdiagnosed such as bronchial asthma or lung cancer. A 50 year old female patient had 10 days of empirical antibiotic therapy with a diagnosis of pneumonia. She has been shipped to our clinic because of the lack of clinical improvement and right hilar mass on chest CT. In bronchoscopy, mucosal infiltration on the entrance of right upper lobe and the endobronchial tumoral lesion before segment junction were seen, biopsy and lavage were performed here. ARB had been found (+ +) in lavage fluid, biopsy was assessed as a granulomatous processes with caseation. The patient received six-month standard antituberculosis treatment. At the end of the sixth month of treatment the right hilar mass completely disappeared on chest CT. In conclusion, EBTB which was mimicing the central bronchial tumor, and successfully treated with anti-tuberculosis treatment is presented in this study. In these cases, bronchoscopy and bronchoscopic material examinations for tuberculosis has a great importance for correct diagnosis and to prevent the bronchial stenosis by early treatment.

Keywords

• Pulmonary Neoplasm, Computed Tomography, Broncoscopy, Tuberculosis

Kaynakça

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