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Tetikkurt C.,Istanbul University | Tetikkurt S.,Taksim Research and Training Hospital | Bayar N.,Istanbul University | Ozdemir I.,Istanbul University
Pneumon | Year: 2010

Endobronchial tuberculosis (EBTB) is the tuberculous infection of the tracheobronchial tree. It has been reported in patients with parenchymal infiltrations and cavities in the lung and intrathoracic tuberculous lymphadenopathy. The occurrence of bronchial lesions in miliary tuberculosis is most likely to be a result of hematogenous dissemination of tubercle bacilli. We report six patients with endobronchial involvement in miliary tuberculosis. Bronchoscopic examination with histopathological evidence is essentialto exclude or confirm endobronchial involvement in military tuberculosis. Chest computed tomography (CT) may be a usefuldiagnostic adjunct for evaluating bronchial stenosis, but does not show the mucosal changes of endobronchial inflammation if thelesions are superficial or mild. Local steroid injection appears to be useful for the treatment of superficial mucosal lesions involving less than one quarter of the bronchial lumen, but for advanced inflammatory lesions local treatment is ineffective. Local steroid injection for the treatment of bronchial narrowing is contraindicated by the finding of significant bronchial or segmental stenosis on CT scan. The evolution of airway involvement in miliary tuberculosis indicates that hematogenous dissemination of the bacilli is the primary mechanism for endobronchial tuberculosis. Source


Tetikkurt C.,Istanbul University | Tetikkurt S.,Taksim Research and Training Hospital | Ozdemir I.,Istanbul University | Zuhur C.,Istanbul University | Bayar N.,Istanbul University
Multidisciplinary Respiratory Medicine | Year: 2010

A 51-year-old man with Behçet's disease complained of fever, dry cough and dyspnea during exertion. Chest CT showed ground glass opacities with interstitial septal thickening in both lungs. Bronchoalveolar lavage (BAL) revealed amorphous and lipoproteinaceous material that was periodic acid-Schiff (PAS) stain positive. Transbronchial biopsy specimen demonstrated PAS positive alveolar eosinophilic material consistent with pulmonary alveolar proteinosis. Serum anti-granulocyte-macrophage colony stimulating factor (GM-CSF) antibody was negative. Recent studies have reported anti-GMCSF not present in the the serum of patients with secondary pulmonary alveolar proteinosis (PAP) but they have not reported so in patients with idiopathic PAP. We report a case of alveolar proteinosis in the setting of Behçet's disease with spontaneous remission. Source

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