肺非定型抗酸菌症のX線学的研究 : 第1報菌種別, 初診時X線所見の比較

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Two hundred eighty one cases of the lung disease due to mycobacteria other than tubercle bacilli (atypical mycobacteria) were found at the seven National Chest Hospitals in Japan during the past several years. Eighteen of 281 cases were the disease due to M. kansasii, 3 due to M. scrofulaceuni, 247 due to M. intracellulare, 11 due to M. chelonei, and 2 due to M fortuitum. The first chest radiograms were observed, and the radiographic features of the disease due to various species of atypical mycobacteria were compared. The results were summerized as follows: (I) Minimal cases and cases without any previous pathological changes in the respiratory organs (primary infection cases) were found more f requently among persons of middle age and younger than among the older persons in the disease due to all the species of atypical mycobacteria. (II) There was no statistically significant difference in the ratio of cavitary cases to the total cases among the various species (83 to 100%). (III) The difference in the radiographic features among various species were as follows. i) In the case of the disease due to group IV organisms (M. chelonei and M. fortuitum), single solitary cavity was found in the lung field, and its shape was round, thin-walled and less than 40mm in diameter in almost all cases. In the case of the disease due to M. kansasii, round, thin-walled cavitary lesions were observed which were similar to that of the disease due to group IV organisms, however, the proportion of cases with multiple (3 and more) cavitations amounted to 16.6% of the total cases, and giant cavity (over 40mm in diameter) was found occasionally. ii) In the case of the disease due to M. intracellulare, subpleural cavitary lesions were found in many cases, while in the case of the disease due to M. kansasii, M. scrofulaceum and M. chelonei, cavitary lesions were found in the lung field in the majority of the cases. iii) In the cases with the lesions localized in one lobe, the lesions were found more frequently (2.7 times) in the right lung than in the left, and the number of cases with the lesions localized in the upper lobes amounted to approximately 90% of the total cases. The number of cases with the lesions localized in the middle lobe was only 2% in the case of M. intracellulare infections. iv) The majority of non-cavitary lesions were infiltrative. Only in the case of the disease due to M. intracellulare, various lesions (diffuse nodular lesions, bronchiectasis and pleural empyema, etc.) were observed. In the case of the disease due to group IV organisms, non-cavitary lesions were not found in most of cases (61.5%). v) The previous pathological changes in the respiratory organs were found in many cases of M. intracellulare infection, but they were found in a few cases of M. kansasii and group IV organisms infection. In the case of the disease due to M. scrofulaceum, pneumoconiosis was found in 2 of 3 cases. (IV) Even among the disease due to the same species of atypical mycobacteria (111. intrace llulare), the radiographic findings differed in different hospitals.
日本結核病学会の論文

肺非定型抗酸菌症のX線学的研究 : 第1報菌種別, 初診時X線所見の比較

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