The classic dictum that pulmonary tuberculosis is a disease located predominantly in
the apices of the lungs often suggests etiologic agents other than the tubercle bacillus
as the cause of isolated lesions in the lower half of the lung fields. Only when tubercle
bacilli are demonstrated in the sputum is the correct diagnosis arrived at.
The comparatively low incidence of this type of tuberculosis on routine admissions
and out-patient clinics have often made the physician unaware of its existence.
Lower lung field tuberculosis was investigated in 924 ambulatory patients at the Seoul
University Health Center from April, 1957 to October, 1963 and in 622 admitted patients
at the Respiratory Department on Internal Medicine, College of Medicine, Seoul
University.
Eighteen cases were found, representing 1.16 percent of the total cases.
A higher incidence of the disease was found in the second decade of life, with
predominance in the right side; and a large number of females were affected than
males(2.26 per cent versus 0.93per cent).
The respiratory symptoms, such as cough, sputum, hemoptysis and chest pain was
more prevalent in the selected group than in the general group of tuberculosis.
A tendency toward massive expectoration of tubercle bacilli was one of our
observation.
The incidence of cavity formation was higher in the lower lung field tuberculosis than
in the general group of tuberculosis (61.1 per cent versus 25.2 per cent).
The cavities in cases were smaller than 4cm, single and they had rarely fluid-level
(1case). The association of the parenchymal lesions with pleural effusion was also rare(l
case).
No atelectasis was found. Endobronchial disease was present in 6 patients(33.3 per
cent).
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