3.9.4 Focus lung tuberculosis


tuberculosisTwo forms of focus lung tuberculosis are distinguished, according to clinical and radiographic point of view: soft focus – more fresh and fibrous focus – in the stage of remission.

On a chest x-ray focuses have sizes up to 1 cm in a diameter, oval or irregular form at soft focus form. Their contours can be distinct or dim, intensity – weak or average. The focuses are single and multiple, more often are settled down in one lung, mainly in the upper lobes: in I, II and VI segments; quite often are merged. Wide linear bound shadows – lymphangitis are visible around focuses. At progression the increase of quantity of the fresh tubercular focuses, aggravation of lympangitis are defined, a field of disintegration appears.

After effective antibacterial treatment the fresh tubercular focuses and lympangitis dissolve usually in 12 months, more often with complete restoration of lung tissue. Less often the fresh focuses are not dissolved after treatment but becoming encapsulated.
So-called productive form is observed at subacute current of the process. The focuses are of average size and fine (3-6 mm), oval or irregular, their forms are precisely outlined, average and high intensity. The focuses settle down separately, do not merge.

At treatment these changes slowly dissolve, during 1,5 and more than years. Frequently focuses are encapsulated, around of them large fibrosis remains. The damaged sites of lungs considerably decrease in volume in result of lung tissue shrinking, up to cirrhosis development.

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