Title:Evaluation of the Agreement Between the Tissue Sample and Bronchoalveolar Lavage (BAL) Fluid in the Diagnosis of Tuberculosis in Patients with Anthracosis
VOLUME: 15 ISSUE: 4
Author(s):Mohammad Samet*, Masoud Rahimian, Samaneh Meshkat and Sanaz Zand
Affiliation:Internal Medicine Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Internal Medicine Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Internal Medicine Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Internal Medicine Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd
Keywords:Anthracosis, biopsy, bronchoalveolar lavage (BAL), bronchoscopy, tuberculosis, patient.
Abstract:Background: Black dust deposited in the lungs is called anthracosis. By damaging
bronchial mucosa, anthracosis can affect the mucociliary cleaning function. Initial reports indicate
that there is a relationship between anthracosis and pulmonary tuberculosis. Due to obstructive
effects of anthracosis on distal airways and disruption in a proper sampling of bronchoalveolar
lavage (BAL), other diagnostic methods are necessary for estimating the tuberculosis prevalence in
these patients. The aims of this study was to evaluate tissue samples adjacent to an anthracotic plaque
for acid-fast bacilli smear and culture.
Methods: This is a cross-sectional analysis study on 100 patients referred to Shahid Sadoughi
Hospital who required bronchoscopy and anthracotic plaque based on bronchoscopy results.
Bronchial fluid lavage, two biopsy samples for culture, and a smear of Mycobacterium tuberculosis
from the surrounding of these plaques were prepared. Data analyses were carried out using SPSS
(version 18).
Results: One-hundred patients og the age range 46-91years were studied. The patients with
tuberculosis diagnosis based on the smear of BAL and bronchial tissue samples and culture of BAL
and bronchial tissue samples were 7%, 13%, 6% and 8% respectively. The presence of granuloma in
histopathology was seen in 15 patients infected with tuberculosis. (κ > 0.04, p-value <0.05). In
patients with positive tuberculosis, culture of bronchoalveolar lavage was superior to other methods.
Conclusion: Diagnostic value of BAL method and tissue biopsy in anthracosis patients with
tuberculosis did not show a statistically significant difference. As compared with other methods,
BAL culture was more positive. Therefore, tissue biopsy is not a good alternative to BAL.
