I just arrived at the office today to see a female patient waiting for me, who turned out to be the middle-aged woman I performed a tracheoscopy on last week. After seeing the pathology report, I was overwhelmed with emotion and recalled the events of last Wednesday. It turned out that this patient had had a cough for six months and had a persistent dry cough. The first chest radiograph reported no abnormality, but fortunately the patient still had this chest radiograph, and I brought it to see that there was in fact a pulmonary atelectasis at that time. However, the patient’s right heart margin has actually changed, as shown by the sharpness of the right heart margin and the irregular translucent area behind the heart margin on closer inspection. Since the radiologist failed to detect this condition and reported normal findings, the clinician gave only symptomatic treatment with cough suppressants. The patient’s cough was intermittent, but never stopped, and he also gradually developed shortness of breath after activity, which did not affect his usual work walking, but he would feel breathless if he moved vigorously. According to this situation, I asked the patient to do a lung CT and found that although the bronchial lumen of the right lower lung was not completely blocked, there were different degrees of stenosis and bronchial wall thickening, and there were also similar manifestations in the left lower lung; the pulmonary function test was severe obstructive ventilatory dysfunction, or more accurately, there were double butterfly changes, which is a special kind of pulmonary function chart that many people misdiagnose as bronchial asthma. So I told the patient to do a bronchoscopy and did so that afternoon. The bronchoscopy revealed the patient’s bronchial stenosis occlusion in the dorsal segment of the left lower lobe, and we performed a biopsy in this area and finally found the underlying cause of the cough that had been bothering the patient for six months. Since our country is a major tuberculosis country, it is important to be alert for bronchial tuberculosis in patients with chronic cough of unknown origin. The clinical symptoms of bronchial tuberculosis are diverse and lack specificity, but the most common is cough, with an incidence of 71-100%, followed by coughing sputum 41-95%, fever 24-50%, dyspnea 20-35%, hemoptysis 20-25%, chest pain 15%, and a small number of patients may have no symptoms at all. Bronchial tuberculosis patients basically have a mild or severe cough, which can be the only manifestation of the disease and is usually not treated with cough suppressants, and some patients can have a pronounced, irritating cough at night. If the bronchial tuberculosis is simple there can be no toxic symptoms of tuberculosis, as in the present patient. As the disease progresses, the bronchial mucosa becomes congested and edematous and hypertrophic, resulting in a local narrowing of the lumen, and a wheezing sound, which some patients can hear themselves, can occur as the air flows through the narrowed area. The symptom that accompanies this condition is dyspnea, an inspiratory dyspnea that usually worsens progressively and is ineffective with bronchodilators. The primary diagnostic tool for bronchial tuberculosis still relies on bronchoscopy, as many patients are sputum-free and the lesions grow submucosally, so bronchoscopic biopsy and brushing must be performed for final clarification. Treatment of bronchial tuberculosis includes pharmacological, interventional and surgical treatment. Pharmacological treatment is the basis, but the treatment time is relatively long, usually taking 12-18 months, and the earlier the diagnosis and timely treatment the more bronchial stenosis can be prevented. On this basis, depending on the different microscopic manifestations, bronchoscopic interventions can be taken to inject drugs into the lesion with a view to maximizing the drug concentration.