Pathological findings
The examination of the biopsy from the right bronchial mucosa unveiled
several significant pathological features. Notably, surface ulceration
was observed, indicating tissue damage and disruption. Furthermore, the
biopsy exhibited the presence of necrotic tissue, suggestive of tissue
death, along with clusters of granulomatous histiocytic cells,
indicative of an inflammatory response. Additionally, a few giant cells
were noted, further supporting the granulomatous nature of the lesion
(Figure 3).
Upon performing Ziehl-Neelsen staining, focal positivity for acid-fast
bacilli was detected within the specimen, consistent with the presence
of Mycobacterium tuberculosis (Figure 3). Notably, the absence of
malignant cells or features excluded the possibility of malignancy.
Based on these detailed pathological findings, the diagnosis was
established as acute on necrotizing granulomatous bronchitis, strongly
indicative of endobronchial and pulmonary tuberculosis.
Figure 3. pathological and Ziehl-Neelsen staining results.