An unusual presentation of tracheobronchial tuberculosis mimicking airway tumor: a case report and literature review.

Tracheobronchial tuberculosis is a special type of pulmonary tuberculosis that poses significant diagnostic challenges due to its nonspecific clinical and radiological manifestations. The tumorous subtype of tracheobronchial tuberculosis is particularly rare and carries a variable clinical course with risk of airway stenosis. A 21-year-old male presented with acute-onset cough, chest tightness, and fever. Chest CT revealed a large obstructive endobronchial mass in the left main bronchus and left upper lobe bronchus, initially misdiagnosed as an airway tumor. Given the severe airway obstruction, the patient underwent bronchoscopic resection of the endobronchial mass for diagnosis and symptom relief. Histopathological analysis of the resected mass and molecular testing of bronchoalveolar lavage fluid confirmed tumorous tracheobronchial tuberculosis complicated with infiltrative pulmonary tuberculosis. The patient received individualized anti-tuberculosis therapy tailored to bronchoscopic findings, and follow-up chest CT showed marked lesion regression without complications such as bronchial stenosis. Tumorous tracheobronchial tuberculosis is an unusual, easily misdiagnosed subtype with a potentially severe prognosis, and it must be carefully considered in the differential diagnosis of endobronchial masses. Timely diagnosis and early initiation of anti-tuberculosis therapy are critical for achieving uncomplicated healing, as demonstrated by this patient's favorable outcome.