부산대학교 도서관

The development of pulmonary aspergilloma in tuberculous cavities was studied, based on serological examinations and chest X-ray films. There were 18 men and 2 women. The mean ages were 43.0 years when pulmonary tuberculosis began and 51.3 years when the results of bacterial examination became negative with treatment of antituberculosis drugs. The average period from the beginning of tuberculosis to negative results was 7.1 years. Among these cases 4 patients converted within a year, one patient within 2 years and 15 patients over 2 years. The mean age was 55.3 years when aspergilloma developed. Two of the patients were 20-39 years old, 10 patients 40-59 and 8 patients 60-79. The mean term from negative results to development of aspergilloma was 3.7 years, 4 patients within a year, 8 patients within 2 years and 8 patients over 2 years. At the present time, 12 patients are alive and their average age is 60.8 years. Eight patients died at an average age of 69.0 years. The mean term from development to death was 7.4 years. when aspergilloma developed, 16 patients had been treated with antituberculosis drugs, 7 with rifampicin. Case 8, 11 and 14 improved after rifampicin was halted. Before aspergilloma were formed, the tuberculous cavities had become thin-walled. It is postulated that there are two categories of aspergilloma formation: bronchogenic dissemination and intracavitary formation. In cases of bronchogenic dissemination, mycetoma is formed in drainage bronchus and disseminates or migrates into the cavity. (1) When check-valued, the cavity has tension and increases in size ‹tension cavity type in 5 patients›. (2) When ventilated inadequately, the cavity becomes smaller or indistinct ‹obstructive type in 6 patients›. In cases due to intracavitary proliferation of Aspergillus, cavities do not change in size in the early stage. Initial findings are as follows (3) the wall of cavity is rough ‹mural rough type in 2 patients›, (4) prominent ‹bud-formative type in 3 patients›, and cavity is opaque ‹diffuse proliferative type in 4 patients›. In some cases, the fluid levels were found in the cavities during development of aspergilloma. In 3 cases, bacterial examination became positive again after aspergilloma had disappeared.