Differential X-ray diagnosis of pseudotuberculous scenario of pulmonary abscess with tuberculous cavities

Abstract

Background. Recent decades in Ukraine have been characterized by a significant increase in the number of tuberculosis patients, often with forming cavities of destruction. X-ray diagnosis of lung cavitary lesions is one of the current issues of modern pulmonology and thoracic surgery. Pulmonary abscesses resemble other diseases with destruction and cavities substantiating the need for differential diagnosis with tuberculosis. Purpose – specifying particular scenarios of X-ray presentation of lung abscess and determining the capability of differential diagnosis of pseudotuberculosis with cavities of tuberculosis etiology. Materials and methods. The paper deals with the analysis of X-ray examination of thoracic viscera provided for 252 patients with lung abscess, aged 18 and up to 78. X-ray radiography in two projections, linear and computed tomography (56 patients involved) were performed. All patients underwent a study over time. Results. Almost in most lung abscess cases, there is a need for differential diagnosis with a range of medical entities. The obtained data have made it possible to suggest a classification of X-ray scenarios of lung abscess. The scenarios of X-ray presentation of acute pulmonary abscess are typical and atypical, among those: cystoid, pseudotuberculous, affected 38 patients (15 %), and pulmonary-pleural. The peculiarities of X-ray presentation of pseudotuberculous scenario along with the differences and signs allowing to make an accurate diagnosis have been specified. Conclusions. X-ray study remains an essential in diagnosing purulent-destructive diseases. Being familiar with the scenarios mentioned above and pseudotuberculous one, in particular, will make it possible to significantly improve diagnosis as well as differential diagnosis of pulmonary abscess.

Keywords

• x-ray diagnosis, pulmonary abscess, pseudotuberculous scenario, tuberculous cavern.