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.