Bronchial tuberculosis - Cytologic diagnosis of fiberoptic bronchoscopic brushings

OBJECTIVE: To determine the cytomorphologic features of bronchial tuberculosis on fiberoptic bronchoscopic brushings and ifs diagnostic value. STUDY DESIGN: Seven hundred forty-six bronchoscopic examinations were 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 cytomorphology; 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, pairs. Acid-fast stain showed that only one brushing was positive (4.3%); all the biopsy specimens were negative. Epithelioid cell granulomas and/or caseous necrosis were found in 23 cases of brush smears, while tuberculous granulomas accounted for 16 bronchial biopsies. Seven were nonspecific chronic bronchitis or normal bronchial mucosa. CONCLUSION: The cytomorphologic alterations of tuberculosis are suitable for diagnosing bronchial tuberculosis on fiberoptic bronchoscopic brushings. Its sensitivity for defining bronchial tuberculosis is not lower than that of bronchial histologic biopsies or bacteriologic examination.