ABSTRACT
Based on the material available in a specialized unit, the authors analyzed a diagnostic process in 731 patients with lung disease. They explored the reasons of erroneous and untimely diagnosis of pulmonary tuberculosis, lung cancer, pneumonia, and other abnormalities. The most important reason was found to be an inadequate technological approach to choosing diagnostic actions.
Subject(s)
Primary Health Care , Tuberculosis, Pulmonary/diagnostic imaging , Adult , Female , Humans , Lung/diagnostic imaging , Tomography, X-Ray ComputedSubject(s)
Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Pulmonary/diagnosis , Antitubercular Agents/administration & dosage , Antitubercular Agents/therapeutic use , Humans , Radiography, Thoracic , Sputum/microbiology , Time Factors , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/classification , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiologyABSTRACT
Two hundred and eighty seven cases of tuberculous pleurisy are analyzed. According to the pleural contents, four phases of development of this disease are identified. These include: 1) free pleurisy; 2) partially encysted pleurisy; 3) encysted pleurisy, and 4) adhesive pleurisy. An algorithm of use of draining procedures and surgical interventions depending on the phase of pleurisy is proposed. Among other things, indications for thoracoscopy that was performed in 66 patients with tuberculous pleurisy for its therapy were stated. Thoracoscopy is ineffective in adhesive pleurisy, in the presence of a rigid residual cavity in particular, and thus preference should be given to thoracotomy with pleurectomy and decortication of the lung. This operation was made in 39 cases. Timely use of draining procedures and surgical interventions make it possible to achieve recovery from tuberculous pleurisy over shorter periods of time and with minimal residual changes.
Subject(s)
Pleurisy/surgery , Tuberculosis, Pleural/surgery , Adolescent , Adult , Algorithms , Drainage , Humans , Male , Patient Selection , Pleura/surgery , Pleurisy/classification , Pleurisy/diagnosis , Radiography, Thoracic , Thoracoscopy , Time Factors , Tuberculosis, Pleural/diagnosisSubject(s)
Bronchial Diseases/diagnosis , Lung Diseases/diagnosis , Biopsy , Bronchial Diseases/diagnostic imaging , Bronchoscopy , Constriction, Pathologic , Diagnosis, Differential , Humans , Lung/pathology , Lung Diseases/diagnostic imaging , Lung Diseases/pathology , Lung Neoplasms/diagnosis , Pneumonia/diagnosis , Pneumonia/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/diagnosisABSTRACT
Fifty eight patients with peripheral tumor-like formations of the lung (33 with cancer and 25 with benign formations) were examined by longitudinal tomography and CT. The potentialities of the two techniques in detecting the major semeiotic signs of cancer and malignant formations were compared. The main or major signs, such as the shape of shadow and the pattern of outlines, which make it possible to differentiate benign and malignant formations, are virtually equally imaged by the two techniques. CT is superior to X-ray longitudinal tomography in revealing minor calcifications and microdestructions, hyperplastic intrathoracic lymph nodes. The significance of some symptoms for differential diagnosis calls for further clarification.
Subject(s)
Lung Diseases/diagnostic imaging , Tomography, X-Ray Computed , Tomography, X-Ray , Adult , Aged , Diagnosis, Differential , Evaluation Studies as Topic , Female , Humans , Lung Neoplasms/diagnostic imaging , Male , Middle AgedABSTRACT
Two hundred and fifteen patients with pulmonary involvement of lobar (regional, segmental) extent were examined. The examination procedure included clinical and laboratory tests, X-ray tomographic study, and computed tomography, bronchoscopy with biopsy, cyto- and histological studies. The nosological diagnosis was established in 96.5% of cases. Differential diagnosis was found to be difficult in 3.5% of cases.
