Evaluation of the agreement between the tissue sample and bronchoalveolar lavage fluid in diagnosis of tuberculosis in patients with anthracosis

Introduction: Anthracosis with damage to bronchial mucosa, can reduce mucociliary cleaning function. Initial reports indicate that there is a relationship between anthracosisand pulmonary tuberculosis. Due to obstructive effects of anthracose on distal airways and disruption in proper sampling of lavage fluid, the other diagnosticmethods seem to be necessary for estimating of the tuberculosis prevalence at these patients. So in this study except bronchoalveolar lavage, we decided toevaluate tissue sample adjacent to anthracotic plaque for acid-fast bacilli smear and culture. Materials and Methods: This is a cross-sectional analysis study of patients referred to Yazd hospital through Jan 2011- Mar 2016, who need bronchoscopy and in bronchoscopy of them anthracotic plaque was observed. After lavage of bronchial fluid,we took two biopsy samples for culture and smear of Mycobacterium tuberculosis from the surrounding of these plaques. Results: In this research 100 patients in the age range of 46-91 were studied. The cases with diagnosis of tuberculosis by smear and culture of bronchial lavage fluid and bronchial tissue samples were 7%, 13%, 6% and 8% respectively. In total, including granuloma in histopathology, 15 have been infected with tuberculosis. These methods had a good agreement and kappa coefficient, and statistically none of the methods was superior to the other. In terms of the number of positive tuberculosis cases among these methods, culture of bronchoalveolar lavage was superior to other methods. Conclusion: Diagnostic value of BAL method and biopsy in patients with anthracosis did not show a statistically significant difference. Positive diagnostic cases of tuberculosis by biopsy method were only one greater than BAL, and BAL culture was more positive than other diagnostic methods. Therefore, tissue biopsy is not a good alternative to bronchial lavage.

کلیدواژه ها:

Anthracosis ، BAL ، Tuberculosis.