PURPOSE: Tuberculous destroyed lung is a sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with destroyed lung due to tuberculosis account for a significant portion of those with chronic lung disease in Korea. However there are few reports in the literature of tuberculous destroyed lung. In this study, we investigated the CT radiologic findings, pulmonary function test, and the relationship between lung function and structure in tuberculous destroyed lung.
METHODS: A retrospective analysis was made for 44 patients who were diagnosed as tuberculous destroyed lung at the Keimyung University Dongsan Hospital between Janunary 2005 and December 2010.
RESULTS: The mean age of patients was 62.2±9.4 years and the male : female ratio was 2.7 : 1. Chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%), emphysema in 13 cases (29.5%), and destruction in 12 cases (27.3%). Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. On CT scan, the mean number of destroyed bronchopulmonary segment was 7.7 (range, 4-14). The most common injured segment was apicoposterior segment of left upper lobe (n=36, 81.8%), followed by superior and inferior segment of left lingular lobe (n=34, 77.3%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by mixed ventilatory defect (n=7) and restrictive ventilatory defect (n=5). The number of injured bronchopulmonary segments showed a significant negative correlation with FVC % predicted (r=-0.379, p=0.001) and FEV1 % predicted (r=-0.349, p=0.02). After adjustment for age and smoking status (pack-years), the number of injured segments also showed a significant negative correlation with FVC % predicted (r=-0.386, p=0.014) and FEV1 % predicted (r=-0.363, p=0.022).
CONCLUSIONS: The patient with tuberculous destroyed lung showed obstructive ventilatory defect commonly and it may be due to bronchiectasis and emphysema on CT scan. There was negative correlation between the extent of destruction of lung and lung function.
CLINICAL IMPLICATIONS: Tuberculous destroyed lung showed obstructive ventilatory defect and the extent of destruction of lung was related to the decreased lung function.
DISCLOSURE: The following authors have nothing to disclose: Chi Young Jung, Young June Jeon, Byung Hak Rho
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