Endobronchial tuberculosis mimicking malignancy: Lessons from a case report

Endobronchial tuberculosis is characterized by the presence of tuberculous lesions within the bronchi, irrespective of the formation of pulmonary lesions. When these lesions are visible, their morphology often raises the differential diagnosis of malignancy. Diagnostic challenges arise as sputum smear tests—crucial for mycobacterial identification—may yield negative results in up to half of the cases. Here, we present a 66-year-old male who exhibited clinical and radiological findings suggestive of malignancy but was ultimately diagnosed with endobronchial tuberculosis through a combination of bronchoscopy, histopathology, and polymerase chain reaction testing. The patient responded favorably to anti-tuberculosis therapy. This case underscores the importance of comprehensive diagnostic strategies for endobronchial tuberculosis, particularly in distinguishing it from tracheal malignancies. • Bronchial tuberculosis mimics malignancy, complicating clinical and radiological diagnosis. • Negative sputum smears occur in ∼50 % of bronchial tuberculosis cases, delaying detection. • Diagnosis relies on bronchoscopy, histopathology, and PCR, enabling effective treatment.