Background Endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) is a diagnostic method for tuberculosis (TB). This study was conducted to determine the efficiency of polymerase chain reaction (PCR) testing for detecting TB lymphadenitis in samples obtained by EBUS-TBNA. Materials and Methods A total of 93 consecutive patients with hilar/mediastinal lymphadenopathies and diagnosed with granulomatous diseases through histopathological evaluation were included in the study. The specimens provided by EBUS-TBNA were evaluated through pathological, microbiological, and molecular tests. Results Eighty-nine (95.7%) of the 93 patients had histopathologically granulomatous diseases by EBUS-TBNA. Tuberculosis was diagnosed in 27 (30.3%) patients and sarcoidosis was diagnosed in 62 (69.7%) patients. Four (4.3%) patients were diagnosed through mediastinoscopy. Endobronchial ultrasound–guided transbronchial needle aspiration had an overall diagnostic efficiency in TB of 96.9%, a sensitivity of 90.9%, and a specificity of 100%. Mycobacterium tuberculosis PCR was positive in 17 of the 30 patients. The sensitivity of PCR was 56.7%, the specificity was 100%, and the general efficiency of the test was 96.4%. Conclusions As a result, the use of M. tuberculosis PCR in the EBUS-TBNA specimens provides a rapid and an accurate diagnosis of TB. Therefore, we recommend the use of M. tuberculosis PCR in the EBUS-TBNA specimens as a rapid diagnostic method for mediastinal lymphadenopathies in patients with suspected TB.

Bronchoesophageal fistula (BEF) is an undesirable consequence of esophageal cancer. A BEF is encountered in 5% to 15% of patients with esophageal cancer. It is generally a life-threatening complication because of the development of recurrent pulmonary infection and sepsis. We present a case with esophageal cancer and acquired BEF. The fistula allowed herniation of the esophageal wall into the endobronchial lumen, causing significant obstruction of the airway lumen, findings not reported previously.

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Non-Hodgkin lymphoma generally affects the thorax in nearly half of the cases, but endobronchial non-Hodgkin lymphoma is rare. A 65-year-old man presented with refractory cough and progressive dyspnea on exertion of 2 months' duration. The patient denied fever, weight loss, or night sweats. A chest x-ray revealed bilateral lower lobe infiltrates. A computed tomography scan of the chest revealed large matted mediastinal lymph nodes without clear margination. Bronchoscopic examination revealed bilateral endobronchial diffuse nodular lesions. Bronchial mucosal biopsy demonstrated B-cell lymphoma. The patient was treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) regimen with near-total resolution of endobronchial and parenchymal lesions.

Introduction: The risk of tuberculosis is higher in cases who have used anti-INF treatments. However, it is not clearly known whether there is a relationship between other biologic agents and the risk of developing tuberculosis or not. We aimed to investigate the prevalence of active tuberculosis among patients with rheumatic disease treated with biologic drugs. Materials and Methods: The study was performed at a tertiary referral center from January 2015 to December 2019. A total of 2000 patients with rheumatic diseases were screened and 461 patients were enrolled in the study due to regular records.They were underwent LTBI screening tests and were followed-up at least 1 year after INF inhibitor treatment initiation. Results: The median age of all patients was 48 (min-max: 19-80). 283 patients (61.3%) were female and 178 (38.7%) were male. The most common diseases were ankylosing spondylitis (67.2%), rheumatoid arthritis (26%) and psoriatic arthritis (5.2%). Anti-TNF treatments were given to 85.2% of all cases and other biologic treatments were given to 14.8%. Tuberculin skin test was applied to 429 patients and 70.4% positivity was found. Quantiferon-TB test was applied to 93 patients and 20.4% positivity was found. 320 patients were treated for LTB1 due to positive tuberculin skin test and/or positive quantiferon-TB test. TB was developed in only one patient out of 393 patients who were treated with anti-TNF treatments and the the prevalence of TB development was found 255/100.000. Conclusion: The incidence of tuberculosis was quite low in our patients with rheumatic disease who were receiving anti-TNF treatment compared to previous studies. Also, in patients who were using other biological treatments, no TB cases were developed.