BRONCHIAL TUBERCULOSIS - CYTOLOGIC DIAGNOSIS OF FIBEROPTIC BRONCHOSCOPIC BRUSHINGS

OBJECTIVE: To determine the cytomorphologic features of bronchial tube rculosis on fiberoptic bronchoscopic brushings and ifs diagnostic valu e. STUDY DESIGN: Seven hundred forty-six bronchoscopic examinations we re retrospectively studied. The patients' macroscopic findings made by fiberoptic bronchoscopic examination, as well as brush cytologic and biopsy findings, were reviewed. RESULTS: Of 746 bronchoscopic brushing specimens, 23 were diagnosed as endobronchial tuberculosis by cytomor phology; that accounted for about 3.1% of cases. The same or a similar diagnosis was made for both specimen types in 16 of the specimen, pai rs. Acid-fast stain showed that only one brushing was positive (4.3%); all the biopsy specimens were negative. Epithelioid cell granulomas a nd/or caseous necrosis were found in 23 cases of brush smears, while t uberculous granulomas accounted for 16 bronchial biopsies. Seven were nonspecific chronic bronchitis or normal bronchial mucosa. CONCLUSION: The cytomorphologic alterations of tuberculosis are suitable for diag nosing bronchial tuberculosis on fiberoptic bronchoscopic brushings. I ts sensitivity for defining bronchial tuberculosis is not lower than t hat of bronchial histologic biopsies or bacteriologic examination.