Ten Cases Report Of Antipycal Chest Tuberculosis And Literature Review

Objective:To discuss the manifestations and CT findings of the atypical Tuberculosis Diseases, analyze the reasons of misdiagnosis of atypical tuberculosis, and to search a suitable way for accurate diagnosis.Methods:Retrospectively analyze the clinical data of ten cases of atypical tuberculosis disease, and review the relevant literatures.Results:After retrospective analysis of the case reports of atypical tuberculosis during the past5years, we find the misdiagnosis rate of atypical tuberculosis is extremely high (71.09%). It may be misdiagnosed as almost all the other chest diseases and various diseases of other system. However, it is mostly to be misdiagnosed as lung tumor and pneumonia. The reasons of why atypical tuberculosis was so easy to be misdiagnosed include:(1) the influence of basic disease and complications;(2) the clinical manifestation of atypical tuberculosis is not specific;(3) the chest imaging is not typical;(4) the positive rate of etiology examination is low, the laboratory examination is not specific as well. To make an accute diagnosis, we should use a variety of means, such as the etiology examination, fibrebronchoscopy and CT/B ultrasound guided percutaneous lung biopsy, and so on.6of the10clinical cases in our report were diagnosed by pathology, and about64.01%of the diagonsied cases in the literatures were made pathologic diagnosis. About24.28%of the diagnosis was made by electronic bronchoscopy, and26.74%was through CT/B ultrasound guided percutaneous lung biopsy. So pathology is of great significance for the diagnosis of atypical tuberculosis. And some less traumatic methods, such as the electronic bronchoscopy and CT/B ultrasound guided percutaneous lung biopsy, have become more and more important for the diagnosis of atypical tuberculosis. If there are no evidence of etiology or pathology, we could give the patients, who were suspected to have tuberculosis, some regular chemotherapy treatment and follow-up in time, observe the changes in clinical manifestations and imaging observation, to make a correct diagnosis.Conclusions:The clinical symptoms and imaging findings of atypical tuberculosis are varied. They are so similar with other disease that the misdiagnosis rate is very high. And it is mostly to be misdiagnosed as lung tumor and pneumonia. To make a corrext diagnosis, we should use a variety of means such as laboratory examination, fibrotic bronchoscopes, CT/B ultrasound-guided lung biopsy, and so on. Pathology is of great significance for the diagnosis of atypical tuberculosis. And some less traumatic methods, such as the electronic bronchoscopy and CT/B ultrasound guided percutaneous lung biopsy, have become more and more important for the diagnosis of atypical tuberculosis.