Non-Tuberculous Cavitary Disease of the Lungs

¹ Assistant in Surgery, Boston University School of Medicine, and Resident in Thoracic Surgery, Sanatorium Division, Boston City Hospital, Boston, Massachusetts.
² Research Associate in Medicine, Harvard Medical School, and Assistant in Medicine, Peter Bent Brigham Hospital, Boston, Massachusetts.

The x-ray film demonstration of pulmonary cavitation is not equivalent to a diagnosis of tuberculosis since a wide variety of other conditions may produce or simulate cavitary disease of the lungs. Based upon a survey of the literature, a compilation has been made of all such entities. In a few of the intra-pulmonary diseases, included for completeness, authenticity has not been established beyond question. One hundred and fortyfive cases of non-tuberculous clinical material observed at the Hermann M. Biggs Memorial Hospital, Ithaca, New York, during a 13-year period have been studied. One hundred and forty-one were instances of acquired non-tuberculous pulmonary pathology and in 98 of these cavitation or rarefaction was noted roentgenologically at some time in the course of the disease, an incidence of approximately 70 per cent. Three cases of lung cyst was encountered and all showed pseudo-cavitation on x-ray film. In one additional patient, the presence of a diaphragmatic hernia simulated cavitary disease of the lung roentgenologically. In determining the etiology of a cavitary process in any specific instance, the roentgen characteristics alone are not sufficiently circumscribed to permit final diagnosis and careful interpretation of diagnostic data obtained from other sources is essential. Since therapy of an excavating lung lesion may vary greatly depending upon the etiology, accurate diagnosis is important.