Abstract: Objective Electromagnetic navigation bronchoscopy (ENB) has been developed as a novel diagnostic tool of peripheral pulmonary nodules. To evaluate the potential value of ENB on diagnosis of sputum-negative pulmonary tuberculosis (PTB), we presented 3 PTB cases who were diagnosed by ENB and then reviewed the relative literatures. Methods During July to September in 2014, 3 adults suspected for PTB underwent ENB at Shanghai Pulmonary Hospital. The sputum smear and culture were repeatedly negative before ENB. And then the previous literatures were reviewed by searching Medline. From 2006 till now, 13 papers from clinical trials that were scientifically designed, containing >10 cases and completed data presented. Results All of 3 patients had been treated with standardized regimen for at least 4 months and had poor effects. CT showed that the lesions were located in the apicoposterior segment of the upper lobes, beyond the reach of conventional bronchoscopes. After being successfully navigated, the lesion locations were confirmed by peripheral ultrasound and specimens were sampled under X-ray assistant. The diagnosis yielded in all the cases with bacterial or pathologic technique. No procedure-rela-ted complications were observed. The results from previous research showed that the diagnose yield and accurate rate for peripheral pulmonary lesions by ENB were as high as 59.0%－98.0% and 59.0%－94.0%, respectively. For malignant lesions, the diagnostic accuracy reached 60.0%－89.5%.  However, little data is available about the clinical utilization of this technique in the diagnosis of pulmonary tuberculosis. Conclusion The ENB may have good applications in diagnosis of atypical pulmonary tuberculosis.

Key words: Tuberculosis, pulmonary/diagnosis, Bronchoscopy