[Formation of multiple tuberculomas in the lung with cystic hypoplasia].
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Biomedical subjects
Publications and source records attributed to I P Zhingel'.
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Surgical biopsy of 536 pulmonary tuberculosis patients was analysed. It was found that in 90% of them tuberculosis developed in the malformed segment of lung tissue. Among the defects, basic matter was composed of small hypoplasia zones (2-3 cm) which were detected only morphologically. In 89% of the cases, zones of hypoplasia and cysts were located in the 1st and 2nd lung segments, which formed in the first postnatal months. In all cases tuberculosis affected the malformed bronchus, which was probably the primary site of tuberculosis process dissemination.
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The intravital diagnosis was established only in 20 patients (19.2 percent) out of 104 persons who died from tuberculosis and its sequelae over the last 20 years at the general hospital. The diagnostic errors were mainly accounted for by the difficulties in the recognition of the acute and generalized patterns of tuberculosis, by grave condition of the patients admitted to the hospital, by predominance among the patients of elderly persons with a number of concomitant diseases, by inadequate examination of the patients (the lack of x-ray, bacteriological and instrumental studies) as well as by the lack of attention on the part of internists to the clinical manifestations of tuberculosis today.
Recently, the number of cases of primary lung carcinoma associated with tuberculosis and posttuberculous lesions has become more frequent. In this connection the problem of early diagnosis of cancer in such patients is gaining clinical importance and becomes urgent. The presence of tumor in such patients is mainly stated by phthisiologists as a result of time course x-ray observations with a delay, in half of the patients at stages III-IV. The time for verification of the diagnosis of lung cancer appears to be especially long when it is associated with active tuberculosis and the processes are located in the same area. The time required for diagnosis of cancer in association with inactive tuberculosis when the processes are anatomically located in different areas is somewhat shorter. However, it takes on an average 2-fold time to verify the diagnosis in patients with associated abnormalities as compared to those with cancer not aggravated by concomitant tuberculosis or posttuberculous lesions in the respiratory organs. Persons with tuberculosis or posttuberculous lesions in the lung require more intent attention as for oncological diseases and the above factors should be considered as additional indications to risk of lung cancer.
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