To determine the value of chest roentgenographic findings in the diagnosis and therapy of endobronchial tuberculosis we analysed roentgenograms of 41 patients with endoscopically confirmed tuberculous involvement of the intrathoracic airways. 40 patients had infiltrates typical for pulmonary tuberculosis predominantly in the upper lobes. Signs of diminished air entry in form of collapse or consolidations were found in 52%. 10 patients had cavities and two had a destroyed lung. In only one patient the chest roentgenogram was completely normal demonstrating a case of isolated endobronchial tuberculosis. During antituberculosis drug therapy radiological signs improved in 38 of 41 patients, but in more than half of the cases stenoses persisted as verified by bronchoscopy. We conclude that endobronchial tuberculosis is usually accompanied by lung parenchyma involvement and that roentgenological findings are characterised by signs of pulmonary tuberculosis in most cases. A normal chest roentgenogram does not exclude endobronchial tuberculosis. Despite roentgenographic improvement during therapy tracheobronchial stenoses may persist. These findings justify to perform early fibreoptic bronchoscopy. Sputum conversion during the clinical course may indicate the most appropriate time for this examination.
Adolescent Adult