Application of bronchoscopy in the diagnosis of atypical pulmonary tuberculosis

Objective To investigate the clinical features of atypical pulmonary tuberculosis,and the effect of bronchoscopy on the diagnosis of atypical pulmonary tuberculosis in basic-level hospitals Methods The clinical data of 28 non-typical pulmonary tuberculosis patients with negative sputum smears,were retrospectively analyzed. Results The clinical features were atypical in 28 patients,and the clinical chest roentgenographic presentations were atypical. Shape in lung as the most common chest roentgenographic presentation accounting for 57. 1%. Norma chest roentgenographic presentation accounting for 14. 3%. Endobronchial abnormal change can be found by bronchoscopy in 28 patients,20 patients had infiltrating inflammatory lesions,2 patients had cheese necrotizing granulomatous lesions,4 patients had proliferative lesion,and 2 patients had fiber-type lesion stenosis. Brush smear specimens obtained from 22 patients( 78. 6%) were podsitive by the brush smear specimens for the presence of acid-fast bacilli,and 6 cases( 21. 4%) had pathological changes of tuber culosis by biopsy,and examination for acid-fast bacilli in sputum was positive in 6 patients( 21. 4%). Twenty-eight cases( 100%) were diagnosed by the joined detection. Conclusion Bronchoscopy has significant clinical value on the diagnosis of atypical pulmonary tuberculosis,and is worthy to be popularized in basic-level hospitals.