(内科学课件）Pulmonary Tuberculosis.ppt

* Today ,we will discuss something about tuberculosis. Tuberculosis is common in china. Many intern said the most surprising finding in our department is that there are so many tuberculosis patient around us. the diagnosed patient will be transfer to special hospital, especial for open tuberculosis. But the respiratory physician can’t totally stay away from tuberculosis in china, because the symptom of tuberculosis in insidious. We take differential diagnosis between tuberculosis,inflammation and carcinoma everyday. Sometimes the result is pneumonia, sometimes the results is tuberculosis. maybe we have been exposed to tubercle b for long time when we get the result. * There are three key words here. First, the pathogenic factor is tubercle bacillus, second, the pathological feature is the formation granulomas, and third immunity triggered by tubercle bacillus is cell mediated hypersensitivity. * There are several feature of tuberculosis. first, a contagious bacterial infection caused by tubercle bacillus. But not all the tuberculosis patient are contagious. Second, the lungs are primarily involved, but the infection can spread to other organs. this is why tuberculosis is terrible. It can affects lung, liver, kidney and many other organs. I will explain these symptom later on. * * But it isn’t resistant to gastric acid. Transmission through the gastrointestinal tract is rare. * 补： * Acid-fast stain test is valuable in the diagnosis of pulmonary tuberculosis. * * * 补 * 补：Granulomas, consisting of aggregates of macrophages, often including multinucleated giant cells and “epithelioid” macrophages together with variable numbers of lymphocytes, are a pathologic hallmark of tuberculosis. Some also exhibit caseating necrosis . * * 补 * 补(前面见图) * 补 * 补 * 补 * * 补 * 补 * * * * * 补 * * 补 * Right upper lobe cavity with abcess formation tuberculoma Satellite lisions develop concomitantly. they can usually be recognized on CT films and are often helpful in distinguis