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http://dx.doi.org/10.4046/trd.2011.71.3.202

CT Radiologic Findings in Patients with Tuberculous Destroyed Lung and Correlation with Lung Function  

Chae, Jin-Nyeong (Departments of Internal Medicine, Keimyung University School of Medicine)
Jung, Chi-Young (Departments of Internal Medicine, Keimyung University School of Medicine)
Shim, Sang-Woo (Departments of Internal Medicine, Keimyung University School of Medicine)
Rho, Byung-Hak (Departments of Radiology, Keimyung University School of Medicine)
Jeon, Young-June (Departments of Internal Medicine, Keimyung University School of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.71, no.3, 2011 , pp. 202-209 More about this Journal
Abstract
Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. Methods: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=-0.379, p=0.001) and forced expiratory volume in one second ($FEV_1$), % predicted (r=-0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=-0.070, p=0.014) and $FEV_1$, % predicted (B=-0.050, p=0.022). Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.
Keywords
Tuberculosis, Pulmonary/complications; Lung Diseases, Obstructive; Tuberculosis; Bronchiectasis;
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1 Kim YJ, Jung CY, Shin HW, Lee BK. Biomass smoke induced bronchial anthracofibrosis: presenting features and clinical course. Respir Med 2009;103:757-65.   DOI   ScienceOn
2 Long R, Maycher B, Dhar A, Manfreda J, Hershfield E, Anthonisen N. Pulmonary tuberculosis treated with directly observed therapy: serial changes in lung structure and function. Chest 1998;113:933-43.   DOI   ScienceOn
3 Im JG, Itoh H, Lee KS, Han MC. CT-pathology correlation of pulmonary tuberculosis. Crit Rev Diagn Imaging 1995;36:227-85.
4 Ashour M, Pandya L, Mezraqji A, Qutashat W, Desouki M, al-Sharif N, et al. Unilateral post-tuberculous lung destruction: the left bronchus syndrome. Thorax 1990; 45:210-2.   DOI   ScienceOn
5 Elkington PT, Friedland JS. Matrix metalloproteinases in destructive pulmonary pathology. Thorax 2006;61:259- 66.   DOI   ScienceOn
6 Jordan TS, Spencer EM, Davies P. Tuberculosis, bronchiectasis and chronic airflow obstruction. Respirology 2010;15:623-8.   DOI   ScienceOn
7 Cleverley JR, Muller NL. Advances in radiologic assessment of chronic obstructive pulmonary disease. Clin Chest Med 2000;21:653-63.   DOI   ScienceOn
8 Madani A, Keyzer C, Gevenois PA. Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema. Eur Respir J 2001; 18:720-30.   DOI   ScienceOn
9 Kinsella M, Muller NL, Abboud RT, Morrison NJ, DyBuncio A. Quantitation of emphysema by computed tomography using a "density mask" program and correlation with pulmonary function tests. Chest 1990;97: 315-21.   DOI   ScienceOn
10 Pande JN, Jain BP, Gupta RG, Guleria JS. Pulmonary ventilation and gas exchange in bronchiectasis. Thorax 1971;26:727-33.   DOI   ScienceOn
11 Loubeyre P, Paret M, Revel D, Wiesendanger T, Brune J. Thin-section CT detection of emphysema associated with bronchiectasis and correlation with pulmonary function tests. Chest 1996;109:360-5.   DOI   ScienceOn
12 Roberts HR, Wells AU, Milne DG, Rubens MB, Kolbe J, Cole PJ, et al. Airflow obstruction in bronchiectasis: correlation between computed tomography features and pulmonary function tests. Thorax 2000;55:198-204.   DOI   ScienceOn
13 Kim YJ, Park JY, Won JH, Kim CH, Kang DS, Jung TH. Lung volumes and diffusing capacity in bronchiectasis: correlation with the findings of high resolutional CT. Tuberc Respir Dis 1999;46:489-99.   DOI
14 Lee BH, Kim YS, Lee KD, Lee JH, Kim SH. Health-related quality of life measurement with St. George's respiratory questionnaire in post-tuberculous destroyed lung. Tuberc Respir Dis 2008;65:183-90.   DOI
15 Ryu YJ, Lee JH, Chun EM, Chang JH, Shim SS. Clinical outcomes and prognostic factors in patients with tuberculous destroyed lung. Int J Tuberc Lung Dis 2011;15: 246-50.
16 Kim HY, Song KS, Goo JM, Lee JS, Lee KS, Lim TH. Thoracic sequelae and complications of tuberculosis. Radiographics 2001;21:839-58.   DOI
17 American Thoracic Society. Lung function testing: selection of reference values and interpretative strategies. Am Rev Respir Dis 1991;144:1202-18.   DOI
18 The global initiative for chronic obstructive lung disease (GOLD). GOLD [Homepage]. GOLD; c2010-2011 [cited 2011 Sep 17]. Available from: http://www.goldcopd. org.
19 Hnizdo E, Singh T, Churchyard G. Chronic pulmonary function impairment caused by initial and recurrent pulmonary tuberculosis following treatment. Thorax 2000;55:32-8.   DOI   ScienceOn
20 Pasipanodya JG, Miller TL, Vecino M, Munguia G, Garmon R, Bae S, et al. Pulmonary impairment after tuberculosis. Chest 2007;131:1817-24.   DOI   ScienceOn
21 Plit ML, Anderson R, Van Rensburg CE, Page-Shipp L, Blott JA, Fresen JL, et al. Influence of antimicrobial chemotherapy on spirometric parameters and pro-inflammatory indices in severe pulmonary tuberculosis. Eur Respir J 1998;12:351-6.   DOI   ScienceOn
22 Lam KB, Jiang CQ, Jordan RE, Miller MR, Zhang WS, Cheng KK, et al. Prior TB, smoking, and airflow obstruction: a cross-sectional analysis of the Guangzhou Biobank Cohort Study. Chest 2010;137:593-600.   DOI   ScienceOn
23 Lee SW, Kim YS, Kim DS, Oh YM, Lee SD. The risk of obstructive lung disease by previous pulmonary tuberculosis in a country with intermediate burden of tuberculosis. J Korean Med Sci 2011;26:268-73.   DOI   ScienceOn
24 Bobrowitz ID, Rodescu D, Marcus H, Abeles H. The destroyed tuberculous lung. Scand J Respir Dis 1974; 55:82-8.
25 Lee JH, Chang JH. Lung function in patients with chronic airflow obstruction due to tuberculous destroyed lung. Respir Med 2003;97:1237-42.   DOI   ScienceOn
26 Willcox PA, Ferguson AD. Chronic obstructive airways disease following treated pulmonary tuberculosis. Respir Med 1989;83:195-8.   DOI   ScienceOn
27 Snider GL, Doctor L, Demas TA, Shaw AR. Obstructive airway disease in patients with treated pulmonary tuberculosis. Am Rev Respir Dis 1971;103:625-40.
28 World Health Organization (WHO). Tuberculosis (TB): global tuberculosis control 2010. Geneva, Switzerland:WHO; c2011 [cited 2011 Sep 16]. Available from: http://www.who.int/tb/publications/global_report/ 2010/en.