LUNG - Tuberculosis (2/2)

See also L75 These are portions of the right lung. On the pleural surface there are adhesions of varying thickness; in some parts the parietal pleura is present as well. The pleural surface shows a number of white nodules up to 1cm in diameter; the cut surface shows extensive tuberculous involvement of all lobes. In the middle and lower lobes, there is little cavitation, but there is extensive cavitation in the upper lobe. The lower lobe, in particular, shows consolidation in addition to the caseous areas, and it is likely that the consolidated areas are areas of tuberculous bronchopneumonia.
This man, apparently young, was admitted to Wellington Hospital from a Japanese fishing vessel, and he died shortly after admission. At autopsy there were numerous purpuric spots on both legs. The right lung weighed 1290g and the left 1000g. Numerous acid-fast bacilli were present in the lesions, and there was also tuberculous bronchopneumonia. The liver weighed 1100g, and showed a micro-nodular cirrhosis. Microscopicallythe liver was fatty and showed alcoholic (Mallory’s) hyaline. Death was ascribed to gram-negative septicaemia and shock, but no other clinical details are available.