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化疗所致痊愈过程中切除残留结核病灶的解剖特点已有过初步报告。但是,延长化疗长期治疗的结果却尚未很好阐明。本文报告94例重症肺结核病人经过治疗后在过去15年内死于他其原因的有关肺脏所见的分析。48例接受了3年以上的化疗。79例痰标本集菌或培养均已阴性4年以上。63例主要残留的病变是细菌阴性的囊性空洞,这些病灶中唯一伴发的是鳞状化生上皮衬于空洞壁上。这种再生上皮在最后发展为支气管肺癌的可能性很大。有40例(47%)死于恶性肿瘤,20例为支气管癌。此外,4例存在有隐性恶性疾病。已证明再生的上皮转变为恶性肿瘤发生于支气管接近治愈空洞处或在致密的纤维组织中。组织学所见
There have been preliminary reports on the anatomical features of resection of residual tuberculosis during chemotherapy-induced recovery. However, the results of prolonged chemotherapy for long-term treatment have not been well clarified. This article reports 94 patients with severe pulmonary tuberculosis who died after treatment for the same reason they saw in the lungs in the past 15 years. 48 patients received chemotherapy for more than 3 years. 79 cases of sputum specimen collection or culture have been negative for more than 4 years. The main residual lesions in 63 cases were bacterial-negative cystic holes, the only of these lesions accompanied by squamous metaplastic epithelium lining the cavity wall. This regenerative epithelium is very likely to eventually develop into bronchial lung cancer. Forty patients (47%) died of malignant tumors and 20 patients had bronchial cancer. In addition, 4 cases had hidden malignant diseases. It has been demonstrated that regenerated epithelium turns into malignant tumors that occur in the bronchus near healing voids or in dense fibrous tissue. Seen from histology