3.9.3 Disseminated lung tuberculosis


To this form military, sub acute disseminated and chronically proceeded disseminated lung tuberculosis is referred.

Milliary lung tuberculosis.

On the chest x-ray multiple, fine (1-2 mm) of the same type focuses, rich and in regular intervals distributed in all lung fields. The focuses are precisely outlined, do not merge. Their intensity is average. Picture of lung vessels is not seen because of a big number of focuses. Focuses can completely dissolve or calcify at reverse development of tubercular process. The quantity of calcified focuses is less, than in the period of dissemination, because of partial dissolving of focuses. Dissemination of focuses is settled down symmetrically, as a rule, in all lung fields, on a background of pneumosclerosis and is kept on for all life. Disintegration of lung tissue appears as thin-walled cavities, at progression of process, owing to trophic changes in lungs. Usually cavities are multiple, oval, identical in a form and in sizes. Therefore they are named “stamped”. Sometimes they are located by a chain, quite often are symmetric in both lungs. They are named as system cavities in such cases.

Subacute disseminatedt tuberculosis.

Subacute disseminated tuberculosis on chest x-ray is characterized by representing larger and merged focuses, lympangitis in the form of peribronchial “couplings” along with multiple fine focuses in both lung fields Cavities are the same, as at miliary tuberculosis, thin-walled, “stamped”.

Chronic disseminated tuberculosis.

On chest x-ray chronic disseminated tuberculosis is characterized by presence of the focuses of various size and intensity, places of formed conglomerates, and also net like fibrosis of the upper lobes. The roots and the vessels of the upper lobes are displaced up. The process is bilateral, but frequently asymmetrical – one lung can be struck more than another. Cavities are thin-walled, but usually deformed. Exudative pleuritis is observed quite often at disseminated tuberculosis.

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