Tuberc Respir Dis.  2011 Sep;71(3):202-209.

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

• Chae JN
• Jung CY
• Shim SW
• Rho BH
• Jeon YJ

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 (FEV1), % 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 FEV1, % 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.

Keyword

Tuberculosis, Pulmonary/complications; Lung Diseases, Obstructive; Tuberculosis; Bronchiectasis

MeSH Terms

Bronchiectasis
Cicatrix
Emphysema
Forced Expiratory Volume
Humans
Korea
Lung
Lung Diseases
Lung Diseases, Obstructive
Pulmonary Atelectasis
Respiratory Function Tests
Retrospective Studies
Smoke
Smoking
Thorax
Tuberculosis
Tuberculosis, Pulmonary
Vital Capacity
Smoke

Figure

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  Figure 1 Tuberculous destroyed lung in a 49-year-old man. (A) Chest radiograph shows marked volume loss in the left lung with dilated bronchus. (B) Chest CT scan shows dilatation of bronchus within the collapsed left lower lobe. CT: computed tomograpy.

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  Figure 2 Correlation between number of destroyed bronchopulmonary segments and FVC, % predicted (A) and FEV1, % predicted (B). FVC: forced vital capacity; FEV1: forced expiratory volume in one second.

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