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A large bleeding ulcer was observed several centimeters proximal to the endobronchial mass. The bleeding lesion was thought to be the origin of the spongy mass because a small part of the mass was still there. No fistula was observed, and the lesion was not biopsied.

Histopathologic analysis of the material revealed a caseous granuloma, and Ziehl-Neelsen stain was positive for acid-fast bacilli. Mycobacterium tuberculosis was identified later on culture. Triple antituberculosis therapy (streptomycin, rifampicin, and isoniazid) was started after the diagnosis of endobronchial tuberculosis was established.

Twelve hours after the removal of the foreign body, widespread crepitations were heard on the left lung with some degree of roentgenologic improvement. Two months after the institution of antituberculosis therapy, almost complete healing was observed with the exception of a few residual infiltrates near the diaphram (Fig 1). other

Discussion

In this case of endobronchial tuberculosis simulating foreign body aspiration, the history did not suggest tuberculosis. Rare coughing in the past was attributed to frequent common colds by the family. There was no history of tuberculosis in any relatives or close contacts.


Figure 1
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