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Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis
Authors:Shingo Nasu  Kunimitsu Kawahara  Yuki Han  Norio Okamoto  Yoshitaka Tamura  Hidekazu Suzuki  Takayuki Shiroyama  Yumiko Samejima  Tomohiro Kanai  Yoshimi Noda  Ayako Tanaka  Naoko Morishita  Kayo Ueda  Shoji Hashimoto  Tomonori Hirashima  Takayuki Nagai
Affiliation:1.Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan; 2.Department of Pathology Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Japan; 3.Department of Infectious Diseases, Osaka Habikino Medical Center, Japan
Abstract:
Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO.
Keywords:cryobiopsy   forceps biopsy   miliary tuberculosis   hypersensitivity pneumonitis
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