Endobronchial Tubercolosis: a peculiar feature of TB often underdiagnosed

Endobronchial Tuberculosis (EBTB) is a particular form of TB non easily recognizable, often dangerous for its consequences and potentially a source of spread of infection in the community. Also its definition doesn't find a unanimity. In fact it has been defined as “tuberculous infection of the tracheo bronchial tree with microbial and histopathological evidence” [1] or a” complication of progressive primary Tuberculosis” [2] or, more simply, a “special form of pulmonary Tuberculosis” [3]. It should be stressed that the presence of signs and symptoms qualifies it as a particular expression of a tubercular disease rather than a tubercular infection. Another point of discussion might regard the clinical role of EBTB considering that in the strict sense of a correct classification of TB it might be allocated among the extrapulmonary forms, therefore subjected to diagnostic problems arising from the variability of their clinical manifestations, even though the close continuity with the remaining part of the respiratory system can better draw the attention of the clinicians in comparison with other extrapulmonary localizations. Despite this more favourable position a delay in the diagnosis may be observed with important and seldom severe consequences. These intrinsic difficulties may have some consequences on the epidemiologic reflexes of EBTB represented by the variability of the data, therefore not always affordable, and by the wide range of percentages reported by different authors. For example Han JK et al. [4] quote a percentage of EBTB between 10 and 40% in patients with active tuberculosis that reach 90% in those who exhibit some degrees of bronchial stenosis. On the other hand Chung Hs and Lee JK report an incidence of 5.88% [5], while others authors [6] report an incidence as high as 50% among their patients who were always submitted to bronchoscopy. Analysing the scanty epidemiological references reported by some of these authors it is impossible to distinguish between a real