Özet:

Twenty-two year old, female patient. Her complaints were dyspnea with exercise and a dry cough of 20 days. A few crepitations were heard during oscultation. Routine laboratory examinations were normal. Restrictive pattern was observed in pulmonary function tests. Tuberculin test was positive (18 mm). She could not give sputum sample for acid-fast bacillus (ARB) examination. Bilateral diffuse peripheral reticular infiltrates dominating in right lung were observed in chest x-ray and right hemidiyaphragma was high with irregular contours. There were peripheral reticular densities in right upper lobe apical, posterior, middle lobe, lower lobe apical; left upper lobe apicoposterior, lower lobe apical segments in high resolution computed tomography. There were focal peribronchial thickenings and ground glass density in right middle lobe. ARB was negative in bronchoalveolar lavage (BAL) and bronchial aspiration fluid. BAL fluid revealed 56% alveolarmacrophages, 30% lymphocytes, 12% PNL, 2% eosinophils. Non-diagnostic findings were observed in transbronchial lung biopsy. Since these tests were non-diagnostic, open lung biopsy was performed. Microscopic histopathological examination revealed scattered granuloma with caseification necrosis compatible with pulmonary tuberculosis. A few tuberculosis bacilli were detected in granuloma by Ziehl-Neelsen staining. The case was presented for atypical radiological findings imitating interstitial lung disease.

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