The Pathology and Bacteriology of Resected Lesions in Pulmonary Tuberculosis

¹ Director of Research, Pathology and Allied Services, Missouri State Sanatorium, Mount Vernon, Missouri.
² Chest Surgeon, Southwest Florida State Tuberculosis Hospital, Tampa, Florida.

1. A pathologic and bacteriologic report has been made on resected specimens from 34 patients who received some form of pulmonary resection. One advanced case was included that did not receive surgery, but received antimicrobial therapy.

2. The most important observation was that rest and antimicrobial therapy not only clears up infiltrations in tuberculous cases, but allows the healing of over 25 per cent of recently developed advanced cases by filling in the cavities with granulation tissue and fibrosis, leaving only stellate scars. This group actually does not need surgery, except as assurance to remove any doubts in the minds of the physician, and give satisfaction to the patient. It will give him a shorter convalescence and protect him against any possibility of recurrence of his disease.

3. Another 10-15 per cent may recover without surgery, but for many valid reasons given before, surgery is advisable.

4. The remainder of seriously ill cases (about 60 per cent) need surgery for recovery, if recovery is possible. About half of these are sent home within six months to a year's time after operation as arrested. This group includes more chronic disease where fibrous adhesions and thick walled cavities prevent the closure of cavities. The other cases of this group represent salvage cases, some of which may be prepared for surgery over longer intervals and ultimately operated on; others belong to the various complications; others are too old; while there is a residue of advanced chronics who have little prospect of ever recovering and who will pass away over the years to come.

5. The bacteriologic findings were not unusual. Only three cases were found where there was a positive smear with negative culture. There were 15 negative and 16 positive cultures made from the resected specimens.

6. The various pathologic changes have been discussed.