Suzuki K
Chest Disease Research Institute, Kyoto University, Japan.
Kekkaku. 1995 Nov;70(11):659-63.
At first, we reviewed radiographic findings of primary pulmonary tuberculosis, secondary pulmonary tuberculosis, pulmonary M. avium complex (MAC) disease without predisposing conditions, and pulmonary tuberculosis in AIDS patient. Infiltrates in lower field, mediastinal lymphadenopathy, and pleural effusion were the characteristics for primary pulmonary tuberculosis, while multiple nodular shadow with/without cavitation in S1,2,6 were the characteristics for secondary pulmonary tuberculosis. In pulmonary MAC disease without predisposing conditions, lesions progressed slowly from a cluster of a small nodules to cystic bronchiectasis with collapse of the segment or the lobe, and it took usually more than 10-years for the whole process interval. The characteristics of pulmonary tuberculosis in AIDS patient were nearly the same as those of primary pulmonary tuberculosis. Secondly, we compared clinical characteristics between pulmonary tuberculosis and pulmonary MAC disease. We reviewed the medical records of hospitalized patients who were diagnosed as pulmonary tuberculosis or pulmonary MAC disease. Systemic compromised host defense, such as diabetes mellitus or malignancy, played a more important predisposing factors in the development of pulmonary MAC disease. The average age of patients with MAC disease was found to be older than those with tuberculosis. By gender women were predominant in MAC disease, while men were predominant in tuberculosis.
首先,我们回顾了原发性肺结核、继发性肺结核、无易感因素的肺鸟分枝杆菌复合体(MAC)病以及艾滋病患者肺结核的影像学表现。下叶浸润、纵隔淋巴结肿大及胸腔积液是原发性肺结核的特征,而S1、2、6区的多发结节影伴或不伴空洞则是继发性肺结核的特征。在无易感因素的肺MAC病中,病变从小结节群缓慢进展为伴有节段或肺叶萎陷的囊性支气管扩张,整个病程通常超过10年。艾滋病患者肺结核的特征与原发性肺结核几乎相同。其次,我们比较了肺结核和肺MAC病的临床特征。我们回顾了诊断为肺结核或肺MAC病的住院患者的病历。全身性宿主防御功能受损,如糖尿病或恶性肿瘤,在肺MAC病的发生中起更重要的易感因素作用。发现MAC病患者的平均年龄高于肺结核患者。按性别划分,MAC病中女性居多,而肺结核中男性居多。