Differential diagnosis of fibrous- cavernous tuberculosis:
1.Pneumonia.
2.Disseminated pulmonary tuberculosis.
3.The central cancer.
4.Chronic abscess.
5.Bronchiectasis.
6.Cirrhotic pulmonary tuberculosis.
Cirrhotic pulmonary tuberculosis.
Cirrhotic pulmonary tuberculosis is formed in the final stage of a long-term ongoing tuberculosis process. Fibrotic changes in the lung and pleura prevail over the specific manifestations of tuberculous inflammation, which are usually represented by separate encapsulated tuberculous foci. Sometimes they are represented by residual slit-like caverns. Sometimes they are represented by residual slit-like caverns.
Cirrhotic tuberculosis is characterized by a gradual increase in fibrotic changes and the progression of left ventricular heart failure. Episodic exacerbations of a specific process may occur.
Forms of cirrhotic tuberculosis depending on the extent of the lesion:
1.Unilateral cirrhotic tuberculosis: ●segmental
●lobar
2.Total cirrhotic tuberculosis
3. Bilateral cirrhotic tuberculosis
The clinical picture:
1.Complaints of shortness of breath and dry cough occur with a limited lesion of cirrhotic tuberculosis.
2.With a common form of cirrhotic tuberculosis, there are complaints of shortness of breath, cough with the release of mucopurulent sputum, periodic hemoptysis, tachycardia, acrocyanosis, peripheral edema, enlarged liver, cystitis. Sometimes they are represented by residual slit- like caverns. There may also be increased heaviness in the right hypochondrium
3.The occurrence of bacterial excretion is an important symptom of exacerbation of cirrhotic tuberculosis.
4.There is a pallor of the skin, acrocyanosis, sometimes dryness and other trophic changes in the skin. Nail plates are deformed and become like watch glasses (the same convex). There may be tachycardia and arterial hypotension.
5.There is an asymmetry of the chest, dullness of percussion sound, weakening of breathing, dry or small bubbling monotonous rales over the affected area with unilateral lesions. Wheezing can become multi-caliber with an exacerbation of a specific process. The chest lags behind when breathing on the side of the lesion.
6.Expansion of the boundaries of cardiac dullness, deafness of heart tones, accent of tone 2 over the pulmonary artery.
X-ray diagnostics of cirrhotic tuberculosis:
It is characterized by limited, total (subtotal) darkening with a displacement of adjacent organs towards the lesion:
1.The shadow shape is wrong.
2.The length of the shadow is segmental, lobar, total
(when the entire lung is affected)
3.The structure of the shadow is heterogeneous
4.Adjacent organs are displaced towards the lesion.
5.Deformation of the bone skeleton (beveled ribs),
Narrowing of the intercostal spaces above the fibrous cavity, expansion of intercostal spaces in the area of development of compensatory emphysema).
6.Increased airiness of the lung tissue in the intact sections due to the development of emphysema.
Differential diagnosis of cirrhotic tuberculosis:
1.Fibrous cavernous pulmonary tuberculosis.
2.Meta-pneumatic cirrhosis or carnification after primary pneumonia.
3.Central cancer.
4.Sarcoidosis.
5.Silicosis.
