Multiplanar Reconstructed Thoracic CT Bronchoscopy in Endobronchial Tuberculosis

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pulmonary tuberculosis is one of the most important health problems in the world (1, 2). Human immunode-ficiency virus (HIV) infection, immigration, multidrug resistance, delay and failure in prevention, diagnosis and treatment cause a high incidence of pulmonary tubrcu-losis (3). Endobronchial tuberculosis (ETBT) is a tracheo-bronchial inflammatory disease caused by tuberculosis bacillus. EBTB has at least three important findings. First, EBTB is a highly infectious and contagious infectious disease. Second, the clinical and radiological features are not specific and misleading causing delay in the definite diagnosis. Third, EBTB causes sequels such as airway steno-sis (4). On the other hand, in EBTB, the incidence of positive sputum smear and culture for Bacille de Koch (BK) may be low. Therefore, a negative sputum sample for TB does not exclude the diagnosis. The gold standard method for diagnosis is invasive fiberoptic bronchoscopy with bronchoscopic samplings (including bronchial washing for smear and culture with tissue biopsy) (2, 4). Clear and normal chest radiography does not rule out EBTB (4, 5). CT scan is more sensitive than chest-x ray in the diagnosis of early endobronchial involvement (5). Multiplanar re constructed thoracic CT has been employed for noninva-sive evaluation of endobronchial lesions. So, multiplanar reconstructed thoracic CT may improve confidence in diagnosis over axial imaging alone (6, 7). Reconstructed images in the coronal plane were carried out for forty patients with endobronchial tuberculosis, by multiplanar reconstructed thoracic CT in Imam-Reza hospital, Mash-had, Iran from 2009 to 2011. All of them underwent chest X-ray and fiberoptic bronchoscopy. The patients' bronchial smear and culture for BK were positive. In addition, tissue from the endobronchial lesion showed granuloma with caseating necrosis. The mean age was 52.8 ± 19.26 (13 to 87) years; 23 (57.5%) were female and 17 (42.5%) were male. The major symptoms were cough, sputum, hemop-tysis, fever, weight loss and night sweating (Table 1). In chest radiography, total or partial collapse of the lobes with volume loss were presented in 40%, consolidation with collapse was detected in 42.5%, mass in 7.5%, cavitary lesion in 5% , extensive involvement with destructive lung in 3.5%. Normal chest-X rays were seen in 3% of the patients. The macroscopic appearance of lesions in fiberoptic bronchoscopy was inflammation, reddened