A study consisting of roentgen examination of the pulmonary tuberculous lesions
obtained from 100 cases of pulmonary resection for tuberculosis at the Thoracic
Surgery Section in 36th Army Hospital Massan, Korea from 1954 through 1956 in
Presented in order to reach soma conclusions concerning the relationship between the
roentgenological character of the chest films and the pathological process of tuberculous
lesions of resected lung The following conclusions were drawn :
1) With the only means of roentgenexamination in the Posterior- Anterior, Lateral and
Oblique projections, it perm its to determine the localization of segmental pulmonary
tuberculous lesions with a fair degree of accuracy(about in 95%), considering of the
normal roentgen projection and qualitative change of pulmonary tuberculosis.
2) On the subject of localization for the pulmonary tuberculous lesion in roen
tgenograms, following consideration should be noted. In the posterior -Anterior
projections, especially in left sides, if there appear to be infiltration below she level of
second anterior rib, it is seen that the pathologic processes usually extend over the
superior segment of lower lobe combined with the lesions of upper lobe. Likewise, when
the lesion in upper lobe spread over the superior segment of Lower lobe in left side, the
patholologic process involving the superior segment to the lower lobe are usually
projected in the P-A view in the Hilar region.
3) Because the lung are radio-transl-ucent, and diseases affecting the parenchyma
cause either an increase or a decrease in the translucency of the organgs, there were no
difference of density in roentgenograms between the caseous lesion and exudative
lesions, excepting she difference of the sharpness of configuration and the distribution of
shadows in roentgenograms.
4) The 53% of pulmonary tuberculous cavities in reseated lung are not revealed the
rarefaction in the Posterior -Anterior view of chest roentgenograms. These cavities are
mostly appeared as though they are large nodular densities (46.3%), tuberculoma (14.6%)
and consolidation (39.1%) in P-A projection, Actually consisting of small cavitation less
than 1.5cm of diameter, cavities which have thick caseous layer, and cicatrized cavities.
5) The configuration, thickness and sharpness of the walls of cavities which reveal
the rarefaction in P-A projection are mostly depend on the degree of increase
collagenous fiber of the wall, existence of perifocalitis and more or less of the caseous
masses which are sticked on the inner surface of tile cavity wall.
6) Contents of the cavity are variable, such as liquid pus, soft caseous masses and
empty, and we found that the contents of the early cavities with aperifocalitis were
usually liquid pus.
7) The 80 cases of 91cases of reseated lung were combined with pleural adhesion
(90%), and 67% of these pleural adhesion were revealed roentgenologically such as
pleural thickning, displasement of trachea intercostal narrowing, sloping rib and elevated
diaphragma.
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