Interstitial changes in the lungs could be caused by vast majority of diseases including tuberculosis, sarcoidosis, hypersensitive pneumonitis, metastatic injury of  the lungs, etc. Differential diagnosis of pulmonary dissemination remains an urgent  and challenging clinical task. This article is a review of published literature and  presentation of a clinical case of a patient with interstitial lung disease. The case  demonstrates diagnostic difficulties in identification the cause of interstitial lung  injuries. Interstitial lung injury was incidentally found in this patient and initially was  considered as disseminated pulmonary tuberculosis. In-depth diagnostic work-up  including lung tissue biopsy allowed diagnosis of lymphoid interstitial pneumonia associated with common variable immune deficiency. This case demonstrates  common misdiagnosis of pulmonary tuberculosis in a patient with interstitial lung injury.

This clinical case shows the experience in concurrently using video-assisted bronchoscopy and endosonography in a patient with mediastinal adenopathy for differential diagnosis between tuberculous and metastatic changes. It demonstrates the possibilities and limitations of using both classical bronchoscopy and transesophageal endosonography with a EUS-b-FNA using echobronchoscope.

В данном клиническом случае представлен первый опыт применения эндосонографии в России и Восточной Европе у ребенка в возрасте до 5 лет с лимфаденопатией средостения. Продемонстрированы особенности применения чреспищеводной эндосонографии эхобронхоскопом (ЭУС-б), представлены преимущества новой методики в сравнении с классической лучевой и иммунодиагностикой лимфаденопатии при подозрении на туберкулез внутригрудных лимфатических узлов.

No abstract