Med pc2

1.  Infections begin in the lungs
 AIDS_ resurgence ,Highly drug resistant strains
Pulmonary Tuberculosis

2. Primary Pulmonary
Tuberculosis
 the usual primary infections
 The Ghon complex _ subpleural lesion ,
enlarged caseous lymph nodes
 The course & fate of primary infection_ quite
variable, asymptomatic , progressive ( infants,
children &immunodeficient adults).Cavitation,
Tuberculous pneumonia, Miliary tuberculosis

6.  Most represent reactivation
 Morphology_Gross-Apex, Hilus, Reinfection,
Regional nodes, Caseous necrosis fibrocalcific
scars, focal pleural adhesions.
Secondary(Reactivation) pulmonary
tuberculosis

7.  Cavitary Fibrocaseous Tuberculosis_ apical,
erosion into bronchiole, growth &
multiplication of tubercle bacilli, cavitary lesion
( yellow –grey caseous material walled off by
fibrous tissue), infective material disseminate
through the air ways( one , many or all lobes),
the lymphatic , the blood
Progressive Pulmonary Tuberculosis

8.  Isolated minute tubercles, confluent caseous
foci, large areas of caseous necrosis, pleural
involvement(serous pleural effusions,
tuberculous empema)
 Massive obliterative fibrous pleuritis
 Mucosal linings of the air ways-endo- bronchial
Tb, endotracheal Tb, Laryngeal seeding,
intestinal Tb
Cavitary fibrocaseous tuberculosis

16.  Lympho-hematogenous dissemination- lungs
other organs ( bone marrow, liver ,spleen ,
retina , isolated organ tuberculosis
 Morphology_ yellow –white, firm without
caseation or cavity
Miliary Tuberculosis

24.  Highly susceptible, highly sensitized, diffuse
bronchopnemonia, lobar pneumonia, no well
developed tubercle
 Clinical course-extent, activity, pattern of
distribution of the tuberculous pulmonary
infection, response to anti TB drugs, resistant
bacilli, Diabetes mellitus, AIDS,reactive
amyloidosis.
Tuberculous
Bronchopneumonia