The Indian Journal of Tuberculosis - LRS Institute of Tuberculosis ...

SUMMARIES OF PAPERS 171
Patients: Sixty non-smoking patients (22 with
systemic sclerosis, 20 with rheumatoid arthritis, 6
with Sjogrens’ syndrome, 5 with SLE, 4 with
dermatopolymyositis and 3 with overlap syndrome)
were examined.
Results: Fifty-five of 60 patients (91.66%) had
abnormal HRCT findings( septal/subpleural
thickening, ground glass pattern. Chest X-ray
showed parenchymal abnormalities in (58.18%) who
had evidence of fibrosis on HRCT. Abnormal
differential cell counts (alveolitis) at BAL were found
in (76.66%). Following types of alveoli tis were
found: pure lymphocytic, pure neutrophilic and
mixed cellularity or with normal patterns. The extent
of reticular and ground glass pattern on HRCT
correlated with neutrophil rate and the lymphocyte/
eosinophil/total count respectively. Lung volumes
were significantly different between these two
radiological patterns.
Conclusion: HRCT is a sensitive tool in detecting
ILD and ranks superior to chest X-ray in collagen
vascular disease patients. The relationship between
the different HRCT patterns and BAL cell profiles
can identity the patients at higher risk of developing
irreversible fibrosis.
Esophageal Diverticuli - A Rare Cause of
Chronic Cough
A.P. Kansal, Charanpreet Singh Grover, Sallrabh
Kansal and Rajesh Rana.
Esophageal diverticula are outpouching of
the wall of the esophagus. These diverticuli are usually
asymptomatic hut may lead to dysphagia, cough or
stricture formation. A case of 60-year female patient
presented with complaints of chronic cough and
dysphagia, since 5 years. Patient had already been
operated for Achalasia Cardia 33 years back. The
dysphagia was non-progressive and more to solids
than to liquids. All routine investigations were normal
except microcytic hypochromic anaemia. Patient had
been on symptomatic treatment since then but the
symptoms persisted and after that the patient reported
to our hospital. Chest X-ray showed a well defined
homogenous opacity contiunous with the hilum and
possibility of malignancy was considered. NCCT
Chest showed epiphrenic diverticulum arising from
lower end of thoracic esophagus with atelectasis in
surrounding posterior basal segment of left lower
lobe. Upper Gastrointestinal Endoscopy showed a
mass obliterating the lumen of esophagus. Barium
swallow study findings revealed dilated esophagus
in its entire length displaying tertiary contractions
due to partial obstruction at lower end with some
herniation of part of stomach superiorly. Biopsy from
the growth confirmed gastric hyperplastic glands with
no evidence of malignancy. A diagnosis of esophageal
diverticuli was made and the patient was treated
symptomatically for its chronic cough which was
due to pressure effects on the respiratory tract. The
case was then advised and referred for surgery.
Endobronchial Tuberculosis – our experience
K.P .Venugopal, P. Rekha, and P. Sukumaran.
Introduction: Endobronchial Tuberculosis is defined
as tuberculous infection of tracheobronchial tree with
microbial or histopathological evidence. It comprises
10-40% of pulmonary tuberculosis (as such rare).
We are presenting our experience with
Endobronchial Tuberculosis.
Setting and Methods: The study was conducted in
the Department of TB & Chest Diseases, Medical
College, Kottayam, a tertiary care hospital. This was
done as a retrospective study of endobronchial
tuberculosis cases detected by fibre-optic
bronchoscopy from 1/8/05 to 1/1/06.
Results: Out of 600 bronchoscopies done for
various indications, 5 turned out to be biopsy
positive for endobronchial tuberculosis.
Mean age was 26 (14 - 48 years) with 3
males and 3 females. All presented with fever, cough
and weight loss, 4 had haemoptysis.
Initial clinical diagnosis was non-resolving
pneumonia in 2, collapse in 2 and asthma in 1. All
were initially sputum AFB negative. Bronchoscopy
showed intraluminal lesions in all and one showed
significant stricture also. Histopathology came as
Indian Journal of Tuberculosis