Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis

Intern Med. 2021 Feb 1;60(3):445-448. doi: 10.2169/internalmedicine.4511-20. Epub 2020 Sep 19.

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; hypersensitivity pneumonitis; miliary tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alveolitis, Extrinsic Allergic*
  • Bronchoscopy
  • Humans
  • Male
  • Mycobacterium tuberculosis*
  • Sputum
  • Tuberculosis, Miliary* / diagnostic imaging