Studies were made on a total of 32 specimens (25 material from resected lungs and 7 material from autopsy) which had been treated with antituberculous medications and the number and forms of giant cells and their relationship to clincal findings were observed.
Results
1) The forms of the giant cells are classified into 8 groups: (1) riped type, (2) granule type with circular and granulated area in the center of the protoplasm, (3) inclusion type which includes “speculated bodies” or “asteroid bodies”, (4) vacuolar type, (5) atrophic or concentrated type, (6) dissociated type, (1) necrotic type and (8) foreign-body type.
2) Depending upon the forms of the giant cells in the foci, these cases are also divided into 6 groups: A group possesses mainly riped type, B group granule type, C group inclusion type, regardless of its number, D group mainly vacuolar type, E group mostly dissociated, atrophic or necrotic types and F group few giant cells.
3) Relation between giant cells and clinical findings.
a) From the roentgenological point of view serious cases belong A and F groups, while convalescent cases to B, C and D groups, and varied cases to E group.
b) Tuberculin reaction is positive in all cases.
c) Tubercle bacilli in sputum are mostly positive in A, E and F groups, and negative in B, C and D groups.
d) Fidrosis and hyalinosis around the foci are slight in general in A, B, C and D groups, while stronger in E and F groups.
e) The foreign-body type is seen around cholesterin and this is treated for a long period of time.
f) The length of the treatment: less than six months-A, within one to two years-B, C and D, longer than the above - E and F.
Except physical strength of the patients and the virulence of the bacilli the variety of these changes seem to rely upon the length of the treatment.
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