[Specific and nonspecific bronchial and regional lymph nodal lesions as a manifestation of synergism in the lymph epithelial system in pulmonary tuberculosis].

The lung and lymph nodes were examined in 130 patients aged 19-70 years, who had been operated on at the Department of Surgery, Saint Petersburg Research Institute of Phthisiology, for pulmonary tuberculosis. The immunopathological changes have close correlations in the bronchi and pulmonary respiratory parenchyma. This gives grounds to regard the lung and lymph nodes jointly as the organ of local immunity (sui generis) and to suggest that there is a synergism of immune reactions. Every gross organism prefers this or that line of development of an inflammatory process in the lung. This choice is predetermined genetically, on the one hand, and caused by other factors, on the other. The latter include the duration of disease, its inclination for the undulating course, and a rather steady-state high activity of inflammation along with concomitant bronchopulmonary pathology that in turn varying in manifestations, depending on the morphofunctional status of BALT. The development of specific bronchial damage in the presence of nonspecific bronchitis argues for the key impact of BALT.

[Active bronchial tuberculosis in respiratory tuberculosis]. / Aktivnyi tuberkulez bronkhov pri tuberkuleze organov dykhaniia.

A total of 1212 patients aged 1.5 to 70 years were examined in 1998 to 2001. Children under 6 years of age underwent bronchoscopy (BS) using a rigid bronchoscope under anesthesia; the remaining had fibrobrochoscopy by sampling with conventional methods. Active bronchial tuberculosis (ABT) was detected in 74 (6.1%) of the 1212 patients. There was a rise in the incidence of ABT from 4.0 to 9.4%; from 4.3 to 10.9% in secondary pulmonary tuberculosis and from 4.2 to 11.2% in primary one. In patients with secondary pulmonary tuberculosis, ABT was more frequently encountered in infiltrative (7.8%) and fibrocavernous (6.2%) pulmonary tuberculosis. A more severe course of ABT was seen in intrathoracic lymph nodal and fibrocavernous pulmonary tuberculosis with a predominance of fistular (19.2%) and ulcerative (46.6%) forms of ABT.