TYPES OF INFLAMMATION IN ENDOBRONCHIAL BIOPSY SAMPLES FROM PATIENTS WITH ENDOBRONCHIAL TUBERCULOSIS

Aim: to determine the frequency of different types of inflammatory reactions detected in the specimens of endobronchial biopsies (EBB), endobronchial cryobiopsies (EBCB) based on the histology test results at the background of different patterns of endoscopic and clinical manifestations of tuberculosis (TB) of trachea and bronchi in patients with respiratory TB. Materials and methods. A cohort retrospective study included 89 patients aged 18 to 84 years with respiratory TB complicated by endobronchial TB detected by bronchoscopy. Serial EBB or EBCB during bronchoscopy examination as well as cytology and histology tests of biopsy specimens were performed for all patients. Results. Depending on the type of inflammatory reaction in EBB/ EBCB specimens, patients were categorized into 3 groups based on the histology tests results: group 1 included 32 patients with TB type granulomatous inflammation, group 2 included 31 patients with granulomatous inflammation of bronchial wall with no evidence of specificity, and group 3 included 26 patients with apparent chronic nonspecific inflammation of bronchial wall. Significant differences were observed in frequency of the occurred inflammatory reactions specified by the histologic examination of bronchobiopsy specimens depending on the endoscopically identified form of endobronchial TB and the prevalence of the specific process at different levels of airway lesions and duration of symptom persistence prior to the verification of endobronchial TB diagnosis by bronchoscopy. Conclusion. More aggressive forms of endobronchial TB with severe inflammation of the bronchial wall and the process extending beyond the basal membrane (infiltrative-ulcerative lesions, bronchonodular fistulas) and widespread processes involving the trachea and main bronchi were significantly more frequently observed in the TB type granulomatous inflammation of the bronchial wall. Granulomatous inflammation with no evidence of specificity, detected in 35% of patients with endobronchial TB, was most frequently observed in the relatively localized infiltrative bronchial TB. In 29% of patients with endobronchial TB, chronic nonspecific inflammation of the bronchial wall was detected in EBB specimens, which may lead to diagnostic errors.