Background: In this study, we investigated the clinical and radiological features of pulmonary tuberculosis patients with smear and culture-negative results and then made diagnoses by histopathological examination.

Methods: The medical records of 354 male patients (mean age 28.3±9.4; range 21 to 47 years) with pulmonary tuberculosis who were treated in our clinic between January 2007 and January 2011 were retrospectively analyzed. Sixteen of the patients (4.5%) had a confirmed diagnosis of pulmonary tuberculosis by histopathological examination.

Results: The most common symptoms included cough (56%), night sweats (25%), and chest pain (25%). The tuberculin skin test (TST) results of 11 patients were obtained, and the mean TST was 15.1±2.7 mm (range 12 to 20 mm). An elevated sedimentation rate was found to be an abnormal laboratory finding. Tuberculoma (50%), exudative lesions (43%), fibroproliferative lesions (12%), consolidation (12%), and tree in bud appearance (12%) were the most common lesions. A cavity was observed in one patient (6%) and bronchiectasis in another (6%). Multilobular localization was found in five patients while 11 had one lobe localization. Sixteen lesions were found in the right lung and eight in the left lung. Right upper lobe involvement was observed in nine patients (56%), right middle lobe in one (6%), right lower lobe in six (37%), left upper lobe in four (25%), and left lower lobe was seen in four patients (25%).

Conclusion: Our study results showed that tuberculoma is the leading tuberculosis form, and it requires histopathological examination. The clinical and radiological signs of pulmonary tuberculosis may be confused with other diseases; therefore, in patients without a definite microbiological diagnosis, histopathological examination may help in the diagnosis of tuberculosis.

Keywords : Clinical features; histopathologic examination; pulmonary tuberculosis; radiological features