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3.9.8 Cavernous lung tuberculosis

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On chest x-ray cavernous lung tuberculosis is characterized by presence of the formed cavity of disintegration, without expressed perifocal zone of inflammation and surrounded by semination of focuses. This form of tuberculosis is intermediate between infiltrative lung tuberculosis with disintegration and fibrous cavernous lung tuberculosis. Depending on a degree of inflammation changes in the wall of a cavity, its thickness and character of contours distinguish the following cavities: pneumonic, elastic, rigid and fibrous.

The pneumonic cavity is formed from infiltration with disintegration and differs by rather precise internal and indistinct outside contours. The thickness of the wall of a cavity depends on size of infiltration and a zone of perifocal inflammation. Sometimes not discharged sequestrums of caseosis can be defined on an internal surface of the cavity wall.

The elastic cavity is formed from pneumonic cavity at favorable current of the tubercular process, when occurs further discharge of caseosis and reduction of perifocal infiltration. The thickness of a cavity wall decreases, and contours become more precise.

The further regress of process at good drainage function of bronchus can go in a direction of formation granulating cavity with the subsequent formation of either a scar or a small focus. The cavity can inflate, its size increases at distortion of bronchus drainage function, its obturation by caseous mass or owing to inflammative stenosis bulb mechanism. The thickness of its wall thus decreases.

The scarring and fibrous tissue is forming at long existence of a cavity, interchange of outbrakes and process subside in surrounded lung tissue, the cavity gets a kind of rigid and fibrotous.

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