3.10 Endoscopic methods of tuberculosis diagnosis


Tracheobronchoscopy. Bronchopulmonary lavage. Medicinal tracheobronchoscopy. Thoracoscopy (pleuroscopy) Endoscopic and non-endoscopic biopsy. All set forth above methods of research are accessible in equipped, specialized medical establishments staffed with the adequately trained personnel.


Combination of bronchi and trachea examination. For bronchoscopy are used a rigid (metal) or flexible bronchoscope with fiber glass optics (bronchofiberscope / fiber-optic bronchoscope). At examination of bronchi estimate a condition and ability of bleeding of the mucous membrane, character of bronchi contents, diameter of a bronchi lumen, elasticity, tone and mobility of a bronchial wall. Other deviations from norm are fixed also. An endoscopic picture is photographed. An examination is finished (if it necessary) by sampling of material pieces for bacteriological and pathologo-anatomical examinations.

Bronchopulmonary lavage.

During bronhoscopy getting of the lavage fluid allows to receive a material for diagnosis verification at negative bacteriological data. Sometimes from the lavage fluid it is possible to reveal MBT, when it is impossible to reveal by other ways.

Thoracoscopy (pleuroscopy).

The examination consists in visual inspection of pleural cavity. It is possible to use other optical devices, for example bronchofiberscope.

Trancebronchial biopsy.

The direct indication of its realization is the presence of a pathology in main, lobe, segmental and subsegmental bronchi.. For biopsy various techniques are used: snap off (biopsy forcepsing), erasure by a curette, brush (spongy or brush biopsy), pressing by porolone sponge (sponge biopsy), punction and aspiration.

Transtoracal needle biopsy.

Is used for getting:

  • of the pleura and lung tissues for histological and cytological investigation;
  • of the biopsy material of lungs, pleura and lymphatic nodes by operation – opening of the chest cavity.

Pleurocentesis (thoracocentesis) and paracentetic biopsy of pleura.

By method of aspiration [needle] biopsy it is possible to take a material from the pleura and the pleural fluid. From a fluid received at pleurocentesis, in sterile tubes select probes for laboratory research. Define(determine) The relative density of a fluid, cell composition liquid are defined etc. Pleurocentesis make by a special needle under the control rontgenoscopy. Usually receive two samples of biopsy material, which investigate hystologically and on MBT presence.

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