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We analyzed retrospectively the clinical data of 9 patients with miliary tuberculosis who had been treated in Kyoto City Hospital during the past 12 years. Majority of our patients were female (7 of 9) and were of elder age-groups (mean age: 68.5 years, range: 56-85 years). The most common symptoms at the first visit were fever, fatigue and loss of appetite, but respiratory symptoms were rather rare and moderate. Some cases showed normal chest radiograms at the onset, but during the course of the disease miliary shadows were noticed in all cases. Tuberculin test and smear examination of sputum were not diagnostic. In 4 cases, fiberoptic bronchoscopy had been performed together with bronchoalveolar lavage (BAL), bronchial washing and transbronchial lung biopsy (TBLB). Smear examination BAL-fluid or bronchial washing for acid-fast bacilli was positive in all 4 cases tested. In 7 cases, serum level of tumor markers (CEA, TPA, SLX, NSE, SCC, CA19-9, CA125, DU-PAN 2 and Elastase I) had been measured under the suspicion of malignant diseases. CEA had elevated in 6 cases, NSE in 2 cases, SLX, TPA, CA19-9, CA125 and DU-PAN 2 in 1 case each, and, as a whole, at least one tumor marker had elevated in 6 of 7 cases tested. Though the degree of such elevation of tumor markers had not been so remarkable except for CA125 in a patient who had been complicated with tuberculous peritonitis, but from these results malignancy had not been' able to rule out.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical studies on nine cases with miliary tuberculosis: serum level of tumor markers and bronchoscopy in differential diagnosis].