Respir Case Rep. 2023; 12(3): 114-118 | DOI: 10.5505/respircase.2023.27676

Antrakozis Zemininde Geliþen Akciðer Kanserini Taklit Eden Endobronþiyal Tüberküloz Olgusu

Sümeyra Kaplan, Ceyda Anar, Muzaffer Onur Turan, Bunyamin Sertogullarindan
Ýzmir Katip Çelebi Üniversitesi Atatürk Eðitim Araþtýrma Has-tanesi, Göðüs Hastalýklarý Bölümü, Ýzmir

Bronþial mukozada antrakotik pigment birikimi ileri dönemde bronþial hipertrofi ve daralma ile sonuçlanmaktadýr. Bu olgumuzda, toplum kökenli pnömoni ön tanýsý ile antibiyotik tedavisi uygulanan ve klinik, radyolojik yanýt alýnamayan hastaya fiberoptik bronkoskopi uygulandý. Bronkoskopide sað akciðer alt lob bazal segmentlerinin mukozasýnýn siyah renkli pigmentle kaplý olduðu ve segment bronþlarýnýn mukozal infiltrasyon ile daraldýðý ve infiltre olduðu izlendi. Bu bulgularla biyopsi ve BAL yapýldý. Patoloji sonucunda kazeifiye nekroz içeren granulomatoz inflamasyon saptandý. Ayni zamanda bronkoalveoler lavajda asido rezistans basil tespit edildi. Antrakotik zemininde tüberküloz tanýsý konan hastaya dörtlü antitüberküloz tedavisi baþlandý. Takibinin 4. ayýnda klinik, mikrobiyolojik ve radyolojik olarak düzelme izlendi.

Anahtar Kelimeler: Antrakozis, Tuberkuloz, Bronkoskopi.

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A Case of Endobronchial Tuberculosis Mimicking Lung Cancer Developing on the Background of Anthracosis

Sümeyra Kaplan, Ceyda Anar, Muzaffer Onur Turan, Bunyamin Sertogullarindan
Department of Chest Diseases, Ýzmir Katip Çelebi Üniversity, Atatürk Training and Research Hospital, Ýzmir, Türkiye

Anthracite pigment accumulation in the bronchial mucosa can lead to bronchial hypertrophy and narrowing in the future. A patient pre-diagnosed with community-acquired pneumonia underwent fiberoptic bronchoscopy (FOB) and was subsequently treated with antibiotics, however no clinical or radiological response could be obtained. Fiberoptic bronchoscopy (FOB) revealed the mucosa of the lower basal segments of the right lung to be covered with black pigment, while the bronchi segments were found to be narrowed with mucosal infiltration. Based on these findings, a biopsy was performed with pre-diagnosis of malignancy developing on the basis of anthracosis. The pathological examination revealed granuloma-tous inflammation with caseified necrosis and acidresistant bacilli in the bronchoalveolar lavage. The patient was diagnosed with tuberculosis on the basis of anthracosis and was thus started on quadruple anti-tuberculosis treatment, and clinical, microbiological and radiological improvement was observed in the 4th month of follow-up.

Keywords: Anthracosis, tuberculosis, bronchoscopy

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ATIF KOPYALA