The phenomenon of "vanishing lung", descriptive of the occurerance of abnormal air
spaces in the process of pulmonary disease, has greately increased in its incidences in
recent years under the effect of chemotherapy. The following case is an example of
"Vanishing lung" observed in tuberculosis during chemotherapy.
Report of a case
The patient was a 33-year-old soldier, who was in a past of active duty during the
war. Diagnosis of pulmonary tuberculosis was first made by army doctor about 3 years
ago. He received chemotherapy from September, 1951, with PAS and ST. And on that
occasion, tuberculous bacilli was said positive in sputum by smear. In December, 1954,
he was hospitalized in our clinic and physical examination revealed diffuse moist rale
audible at any pals of the lung and marked clubbed fingers. Tuberculous bacilli was
negative in sputum and E.S.R a was normal. Raentogenogram showed, as seen in Fig. I.
A, extensive. rather soft lesion in left upper field of lung and generally severe marking
in both lungs. He was given INAH 400㎎ and PAS 10g daily. Subsequently. though
there was solute improvement of general condition, moderate degree of dyapnea was
persisting. In February 1955, for the purpose of inhibiting fibrosis, cortisone was tried
with daily dose of 50㎎, total amount being 500㎎. but this was not so effective. In
tuberculosis, confluent extensive processes as a rule result either in thick walled cavities
or in dense fibrosis. Now, in this case ,it is considered that chemotherapy, especially the
effect of INAH, and partly the effect of cotisone brought about complete resolution of
pathological products before any of these changes could occur. Another current trend to
explain "vanishing lung" is as a phenomenon of obstructive emphysema. But it is said
that there is neither clinical evidence of bronchial obstruction before its development nor
evidence for such obstruction in subsequent morphological change.
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