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ISSN 2594-1526 (Electronic)
Antes Revista del Instituto Nacional de Enfermedades Respiratorias

 Ver anteriores al 2010

2015, Number 1

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Neumol Cir Torax 2015; 74 (1)

Giant healed non-collapsed pulmonary cavities mimicking emphysematous bullae

Fuentes-Valdés E, Ekumba A

Language: Spanish
References: 20
Page: 13-17
PDF size: 198.98 Kb.


ABSTRACT

Radiographic images and symptoms of healed non-collapsed pulmonary tuberculous cavities can mimic emphysematous bullae. Objective: To identify characteristics that facilitate the differential diagnosis between both entities, preoperatively. Material and methods: We present four patients treated between March and December 2010, referred to thoracic surgery with radiologic diagnosis of emphysematous giant bullae, previously treated by pulmonary tuberculosis. Results: The first patient was operated on with diagnosis of giant emphysematous bulla. Pathological findings defined the actual diagnosis: healed non-collapsed pulmonary cavity. Anamnesis and previous radiographies facilitated the differential diagnosis in the remaining three patients. Surgical indications were the presence of the cavity (› 8 cm) accompanied by mild to moderate dyspnea. A patient developed a bronchopleural fistula, empyema and hemoptysis requiring antituberculous treatment due to the possibility of tuberculosis reactivation. Nonetheless, tuberculous bacillus was not demonstrated. Conclusions: In geographic areas with high prevalence of pulmonary tuberculosis, the history of this disease and the presence of pulmonary cavities in the affected lobe, after finishing the medical treatment, the diagnosis of healed non-collapsed cavity must be suspected, instead of emphysematous bullae.


REFERENCES

  1. Gadkowski LB, Stout JE. Cavitary pulmonary disease. Clin Microbiol Rev 2008;21(2):305-333. doi: 10.1128/CMR.00060-07.

  2. Tuddenham WJ. Glossary of terms for thoracic radiology: recommendations of the Nomenclature Committee of the Fleischner Society. AJR Am J Roentgenol 1984;143:509-517.

  3. Corbett EL, Marston B, Churchyard BJ, De Cock KM. Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment. Lancet 2006;367(9514):926-937.

  4. Auerbach O. Pulmonary tuberculosis after the prolonged use of chemotherapy. Am Rev Tuberc 1955;71(2):165-185.

  5. Schluger NW, Rom WN. The host immune response to tuberculosis. Am J Respir Crit Care Med 1998;157(3 Pt 1):679-691.

  6. Winer-Muram HT, Rubin SA. Thoracic complications of tuberculosis. J Thorac Imaging 1990;5(2):46-63.

  7. Kazerooni EA. Radiologic evaluation of emphysema for lung volume reduction surgery. Clin Chest Med 1999;20(4):845-861.

  8. Xu T, Cheng I, Mandal M. Automated cavity detection of infectious pulmonary tuberculosis in chest radiographs. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:5178-5181. doi: 10.1109/IEMBS.2011.6091282.

  9. Guimaraes CA. Massive hemoptisis. In: Pearson, editors. Thoracic surgery. New York: Churchill Livingstone; 1995. p. 581-596.

  10. Dewan RK. Surgery for pulmonary tuberculosis -a 15- year experience. Eur J Cardiothorac Surg 2010;37(2):473-477. doi: 10.1016/j.ejcts.2009.08.026.

  11. Bouchikh M, Smahi M, Ouadnouni Y, et al. Pneumonectomy for active and sequelae forms of tuberculosis. Rev Mal Respir 2009;26(5):505-513.

  12. Rodríguez M, Munita-Sepúlveda JM, Pérez D, Bannura F, Rodríguez JC, Rodríguez P. Surgery for pulmonary tuberculosis. Review of 33 operated patients. Rev Med Chil 2009;137(2):234-239. doi: /S0034-98872009000200007.

  13. Shiraishi Y, Katsuragi N, Kita H, Tominaga Y, Kariatsumari K, Onda T. Aggressive surgical treatment of multidrug-resistant tuberculosis. J Thorac Cardiovasc Surg 2009;138:1180-1184. doi: 10.1016/j.jtcvs.2009.07.018.

  14. Iuchi K, Nakajima Y. Surgical treatment of mycobacteriosis. Kekkaku 2007;82(11):849-861.

  15. Kaneda M, Tarukawa T, Watanabe F, Adachi K, Sakai T. Surgical treatment for chronic lung and thoracic cavity infection. Gen Thorac Cardiovasc Surg 2009;57(1):98-103. doi: 10.1007/s11748-008-0291-2.

  16. Sihoe AD, Shiraishi Y, Yew WW. The current role of thoracic surgery in tuberculosis management. Respirology 2009;14(7):954-968. doi: 10.1111/j.1440-1843.2009.01609.x.

  17. Corpse RF, Stergus I. Open healing of tuberculous cavities. Am Rev Tuberc 1957;75(2):223-241.

  18. Kaplan G, Post FA, Moreira AL, et al. Mycobacterium tuberculosis growth at the cavity surface: a microenvironment with failed immunity. Infect Immun 2003;71(12):7099-7108.

  19. Camp PC, Sugarbaker DJ. Surgical interventions for emphysema. Semin Thorac Cardiovasc Surg 2007;19(2):157-171.

  20. Sabirov Shlu, Kariev TM, Samatov EV. Pulmonectomy in disseminated destructive tuberculosis complicated by spontaneous pneumothorax and pleural empyema. Probl Tuberk Bolezn Legk 2003;(6):23-25.




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