Roentgenologica1 Study for Pulmonary Tuberculous Lesions of the Resected Lung

Abstract

A study consisting of roentgen examination of the pulmonary tuberculous lesions obtained from 100 cases of pulmonary resection for tuberculosis at the Thoracic Surgery Section in 36th Army Hospital Masan, Korea from 1951 through 1956 in Presented to reach some conclusion concerning the relationship between the roentgenological character of the chest films and the pathological process of tuberculous lesions of resected lung The following conclusions were drawn : 1) With the only means of roentgen examination in the Posterior- Anterior, Lateral and Oblique projections, it permits to determine the localization of segmèntal pulmonary tuberculous lesions with a fair degree of accuracy(about in 95%), considering of the normal roentgen projection of the pulmonary segments, configuration and qualitative characteristics of the roentgenological changes of pulmonary tuberculosis.2) On the subject of localization for the pulmonary tuberculous lesion in roentgenograms, following consideration should be noted. In the posterior -Anterior projections, especially in left sides, if there appear to be infiltration below the level of second anterior rib, it is seen that the pathologic processes usually extend over the superior segment of lowe conbined with the lesions of upper lobe. Likewise, when the lesion in upper lobe spread over the superior segment of Lower lobe in left side, the patholologic process involving the superior segment fo the lower lobe are usually projected in the P-A view in the Hilar region.3) Because the lung are radio-translucent, and diseases affecting the parenchyma cause either an increase or adecrease in the translucency of the organs, there were no difference of density in roentgenograms between the caseous lesion and exudative lesions, excepting the difference of the sharpness of configuration and the distribution of shadows in the roentgenograms.4) The 53% of pulmonary tuberculous cavities in resected lung are not revealed the rarefaction in the Posterior Anterior view of chest roentgenograms. These cavities are mostly appeared as though they are large nodular densities (46.3%), tuberculoma (14.6%) and consolidation (39.1,%) in P-A projection, Actually consisting of small cavitation less than 1. 5cm of diameter, cavities which have thick caseous layer, and cicatrized cavities.5) The configuration thickness and sharpness of the walls of cavities which reveal the rarefaction in P-A projection are mostly depend on the degree of increased collagenous fiber of the wall， existence of perifocalitis and more or less of the caseous masses which are sticked on the inner surface of the cavity wall.6) Contents of the cavity are variable, such as liquid pus, soft caseous masses and empty, and we found that the contents of the early cavities with aperifocalitis were usually liqid pus.7) The 80 cases of 91cases of resected lung were conbined with pleural adhesion (90%), and 67% of these pleural adhesion were revealed roentgenologically such as pleural thickning, displascment of trachea intercostal narrowing, sloping rib and elevated diaphragma.