PATHOLOGICAL DIFFERENCES OF TULAREMIA AND TUBERCULOSIS IN THE LYMPHNODE

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概要

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• Histological examinations were made on tularemia and tuberculosis to compare both diseases, using removed lymphnodes of the former and the lymphnodes which were obtained from autopsy cases and the removed ones of the latter.<BR>Results obtained were as follows:<BR>1) As the case of Ranke's classification on tuberculosis, stage of the primary complex and that of the early generalization were observed in tularemia which was lacking in stage of the late generalization and the 3rd stage. Most of the cases of tularemia in Japan were confined to the formation of the primary complex.<BR>2) Formation of granuloma and its healing process in tularemia was fundamentally identical with tuberculosis. The lesion of tularemia, however, consited of a large amount of polymor phnuclear leukocytes and large mononuclear cells, forming a widespread abscess in it's central part. In tuberculosis, infiltration of polymorphnuclear leukocytes was unexpectedly intense in the lesions of the primary complex and the stage of the early generalization. It was, however, slight or completely absent in lesions of the stage of the late generalization and the 3rd stage, in which large mononuclear cells were mainly infiltrated.<BR>3) In tularemia, argyrophil fibers were completely disappeared in the abscess or homoge neous necrotic area of the central part of the lesion. On the other hand in tuberculosis, they were abundantly observed in the form of nodular networks in the caseous area of the lesions of the stage of the late generalization and the 3rd stage. This may give the evidence of the fact that the caseous area was made by fusion of many lesions caused by caseation of each tubercle. Argyrophil fibers, however, were widely disappeared in caseous areas of the primary complex and the stage of the early generalization by influence of leukocytic infiltrations, though they were observed in reticular or stringy arrangement in advanced portion of the caseous area.<BR>Conclusively, complete disappearance of argyrophil fibers in the central necrotic area of the lesion was one of the most important differrentiation to distinguish tularemia from tuberculosis.<BR>4) Spontaneous healing process of granuloma in tularemia was markedly accelerated by the treatment with antibiotics such as streptomycin6; epithelioid cell zone was replaced by non specific granulation tissue, and organization was occurred even in the central necrotic area. This process was identical with a tuberculous lesion, and was expressed merely in exaggeration as compared with tuberculosis.

• 一般社団法人 日本結核病学会の論文

著者

• 武田 英子

  福島県立医科大学

関連論文

• PATHOLOGICAL DIFFERENCES OF TULAREMIA AND TUBERCULOSIS IN THE LYMPHNODE
• FORMATION OF TUBERCULOUS GRANULOMA IN THE LYMPHNODE AND ITS HEALING PROCESS

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