Abstract
I subjected 943 cases of lung tuberculosis to bronchoscopic examinations and with some of them made an observation of the inside of the bronchial tubes using an optical instrument enabling to examine sideways (90°) and obliquely (0°-60°).
1) Bronchial tuberculosis was observed in 596 cases (63.2%). It was often observed in the patients with aggravated lung lesions, with exudative process, with cavities in the lungs, with sputa bacilli-positive. It was confirmed, as has been reported by various writers, that bronchial tuberculosis is closely related with pulmonary lesions.
2) Bronchial stricture was observed in 78 (15.3%) out of 511 in-patients. There were 33 cases of inflammatory stricture, 34 cases of cicatricial stricture, 11 cases of mechanical stricture. This stricture was found oftener in females than in males with a proportion of 3: 1, and oftener in the left bronchus than in the right, and often at the left main bronchus and its peripheral ending and the right upper lobe orifice. Many of these cases presented the so-called “bronchus syndrome”. those with peculiar clinical symptoms being 73.1%, those with peculiar X-ray findings being 46.2%. These cases generally took unfavorable courses.
3) In 113 cases of tuberculosis in the left lung and 120 cases of tuberculosis in the right lung, bronchial tuberculosis was distributed in the left superior division of the lower lobe (42.5%), in the left upper lobe (31.9%) and in the right upper lobe (30%). According to X-ray findings, I classified the cases into those with the lesion in the upper lobe, those with the lesion in the middle and lower lobes, those with opaque lungs etc. In any of these cases, those with the lesion in the superior division of the lower lobe numbered most.
I explained upon these observations that it was because pathomorphological changes are extremely liable to occur in the left main bronchus, at the peripheral ending of which the upper lobe and the superior division of the lower lobe with high contraction percentages open, that advanced bronchial tuberculosis is often found in the left bronchus. I also maintained that anatomical and pathomorphological knowledge of the bronchi is required for the treatment and bronchoscopic examination of lung tuberculosis.
