Clinicopathological and immunological studies of pulmonary tuberculosis in the aged

Nobuyoshi Miyazaki, Osamu Ogushi, Kazuyuki Higuchi, Yoichi Nakanishi, Osamu Kohashi, Nobuaki Shigematsu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Two cases of aged patients with pulmonary tuberculosis were presented. Their clinical, roentgenological and pathological findings were far different from those of typical pulmonary tuberculosis in adult. To clarify the causes of this atypical manifestation in the aged patients, clinical and immunological characteristics of newly diagnosed tuberculosis in 33 cases of elderly patients, were compared with those in 23 cases of teens and 30 cases of twentieth, and the results were summarized as follows: 1) An extensive distribution of tram lines and acinar patterns was observed radiographically in the presented two cases. These radiographical findings were indistinguishable from chronic airway infections. In addition, there were little or no cavitary changes in these lesions. 2) In autopsy of the first case, the lung presented many scattering foci with small caseous necrosis, around which macrophages (not epithelioid cells) and relatively few lymphocytes were seen. In drainage bronchioles of small caseous lesions a good many polymorphonuclear leukocytes were infiltrated and a few tubercle bacilli were detected. (This was different from the lesions in patients treated with corticosteroid, where numerous tubercle bacilli were proved.) Carnification was also seen around these scattered caseous foci. 3) Reactivity to Mantoux test was reduced in patients over 60 years and it was not associated with numbers of peripheral blood lymphocytes. 4) Lymphocyte blastformation by PHA was, however, significantly reduced in old patients over 70 years. The number of T lymphocytes of tuberculous patients tended to decrease with age, but it was statistically insignificant. These results described above suggested that diagnostic difficulties in elderly tuberculous patients related to their atypical roentgenologic manifestations and their increased negative Mantoux tests and negative sputum, which were mainly due to decreased immunologic responsiveness increasing with age.

Original languageEnglish
Pages (from-to)427-433
Number of pages7
JournalKekkaku(Tuberculosis)
Volume58
Issue number8
DOIs
Publication statusPublished - Jan 1 1983
Externally publishedYes

Fingerprint

Pulmonary Tuberculosis
Lymphocytes
Bacillus
Bronchioles
Epithelioid Cells
Sputum
Drainage
Autopsy
Adrenal Cortex Hormones
Tuberculosis
Neutrophils
Necrosis
Macrophages
T-Lymphocytes
Lung
Infection

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Miyazaki, N., Ogushi, O., Higuchi, K., Nakanishi, Y., Kohashi, O., & Shigematsu, N. (1983). Clinicopathological and immunological studies of pulmonary tuberculosis in the aged. Kekkaku(Tuberculosis), 58(8), 427-433. https://doi.org/10.11400/kekkaku1923.58.427

Clinicopathological and immunological studies of pulmonary tuberculosis in the aged. / Miyazaki, Nobuyoshi; Ogushi, Osamu; Higuchi, Kazuyuki; Nakanishi, Yoichi; Kohashi, Osamu; Shigematsu, Nobuaki.

In: Kekkaku(Tuberculosis), Vol. 58, No. 8, 01.01.1983, p. 427-433.

Research output: Contribution to journalArticle

Miyazaki, N, Ogushi, O, Higuchi, K, Nakanishi, Y, Kohashi, O & Shigematsu, N 1983, 'Clinicopathological and immunological studies of pulmonary tuberculosis in the aged', Kekkaku(Tuberculosis), vol. 58, no. 8, pp. 427-433. https://doi.org/10.11400/kekkaku1923.58.427
Miyazaki N, Ogushi O, Higuchi K, Nakanishi Y, Kohashi O, Shigematsu N. Clinicopathological and immunological studies of pulmonary tuberculosis in the aged. Kekkaku(Tuberculosis). 1983 Jan 1;58(8):427-433. https://doi.org/10.11400/kekkaku1923.58.427
Miyazaki, Nobuyoshi ; Ogushi, Osamu ; Higuchi, Kazuyuki ; Nakanishi, Yoichi ; Kohashi, Osamu ; Shigematsu, Nobuaki. / Clinicopathological and immunological studies of pulmonary tuberculosis in the aged. In: Kekkaku(Tuberculosis). 1983 ; Vol. 58, No. 8. pp. 427-433.
@article{93243d91720a44e6be8ebb03ad0dd795,
title = "Clinicopathological and immunological studies of pulmonary tuberculosis in the aged",
abstract = "Two cases of aged patients with pulmonary tuberculosis were presented. Their clinical, roentgenological and pathological findings were far different from those of typical pulmonary tuberculosis in adult. To clarify the causes of this atypical manifestation in the aged patients, clinical and immunological characteristics of newly diagnosed tuberculosis in 33 cases of elderly patients, were compared with those in 23 cases of teens and 30 cases of twentieth, and the results were summarized as follows: 1) An extensive distribution of tram lines and acinar patterns was observed radiographically in the presented two cases. These radiographical findings were indistinguishable from chronic airway infections. In addition, there were little or no cavitary changes in these lesions. 2) In autopsy of the first case, the lung presented many scattering foci with small caseous necrosis, around which macrophages (not epithelioid cells) and relatively few lymphocytes were seen. In drainage bronchioles of small caseous lesions a good many polymorphonuclear leukocytes were infiltrated and a few tubercle bacilli were detected. (This was different from the lesions in patients treated with corticosteroid, where numerous tubercle bacilli were proved.) Carnification was also seen around these scattered caseous foci. 3) Reactivity to Mantoux test was reduced in patients over 60 years and it was not associated with numbers of peripheral blood lymphocytes. 4) Lymphocyte blastformation by PHA was, however, significantly reduced in old patients over 70 years. The number of T lymphocytes of tuberculous patients tended to decrease with age, but it was statistically insignificant. These results described above suggested that diagnostic difficulties in elderly tuberculous patients related to their atypical roentgenologic manifestations and their increased negative Mantoux tests and negative sputum, which were mainly due to decreased immunologic responsiveness increasing with age.",
author = "Nobuyoshi Miyazaki and Osamu Ogushi and Kazuyuki Higuchi and Yoichi Nakanishi and Osamu Kohashi and Nobuaki Shigematsu",
year = "1983",
month = "1",
day = "1",
doi = "10.11400/kekkaku1923.58.427",
language = "English",
volume = "58",
pages = "427--433",
journal = "Kekkaku",
issn = "0022-9776",
publisher = "Japanese Society for Tuberculosis",
number = "8",

}

TY - JOUR

T1 - Clinicopathological and immunological studies of pulmonary tuberculosis in the aged

AU - Miyazaki, Nobuyoshi

AU - Ogushi, Osamu

AU - Higuchi, Kazuyuki

AU - Nakanishi, Yoichi

AU - Kohashi, Osamu

AU - Shigematsu, Nobuaki

PY - 1983/1/1

Y1 - 1983/1/1

N2 - Two cases of aged patients with pulmonary tuberculosis were presented. Their clinical, roentgenological and pathological findings were far different from those of typical pulmonary tuberculosis in adult. To clarify the causes of this atypical manifestation in the aged patients, clinical and immunological characteristics of newly diagnosed tuberculosis in 33 cases of elderly patients, were compared with those in 23 cases of teens and 30 cases of twentieth, and the results were summarized as follows: 1) An extensive distribution of tram lines and acinar patterns was observed radiographically in the presented two cases. These radiographical findings were indistinguishable from chronic airway infections. In addition, there were little or no cavitary changes in these lesions. 2) In autopsy of the first case, the lung presented many scattering foci with small caseous necrosis, around which macrophages (not epithelioid cells) and relatively few lymphocytes were seen. In drainage bronchioles of small caseous lesions a good many polymorphonuclear leukocytes were infiltrated and a few tubercle bacilli were detected. (This was different from the lesions in patients treated with corticosteroid, where numerous tubercle bacilli were proved.) Carnification was also seen around these scattered caseous foci. 3) Reactivity to Mantoux test was reduced in patients over 60 years and it was not associated with numbers of peripheral blood lymphocytes. 4) Lymphocyte blastformation by PHA was, however, significantly reduced in old patients over 70 years. The number of T lymphocytes of tuberculous patients tended to decrease with age, but it was statistically insignificant. These results described above suggested that diagnostic difficulties in elderly tuberculous patients related to their atypical roentgenologic manifestations and their increased negative Mantoux tests and negative sputum, which were mainly due to decreased immunologic responsiveness increasing with age.

AB - Two cases of aged patients with pulmonary tuberculosis were presented. Their clinical, roentgenological and pathological findings were far different from those of typical pulmonary tuberculosis in adult. To clarify the causes of this atypical manifestation in the aged patients, clinical and immunological characteristics of newly diagnosed tuberculosis in 33 cases of elderly patients, were compared with those in 23 cases of teens and 30 cases of twentieth, and the results were summarized as follows: 1) An extensive distribution of tram lines and acinar patterns was observed radiographically in the presented two cases. These radiographical findings were indistinguishable from chronic airway infections. In addition, there were little or no cavitary changes in these lesions. 2) In autopsy of the first case, the lung presented many scattering foci with small caseous necrosis, around which macrophages (not epithelioid cells) and relatively few lymphocytes were seen. In drainage bronchioles of small caseous lesions a good many polymorphonuclear leukocytes were infiltrated and a few tubercle bacilli were detected. (This was different from the lesions in patients treated with corticosteroid, where numerous tubercle bacilli were proved.) Carnification was also seen around these scattered caseous foci. 3) Reactivity to Mantoux test was reduced in patients over 60 years and it was not associated with numbers of peripheral blood lymphocytes. 4) Lymphocyte blastformation by PHA was, however, significantly reduced in old patients over 70 years. The number of T lymphocytes of tuberculous patients tended to decrease with age, but it was statistically insignificant. These results described above suggested that diagnostic difficulties in elderly tuberculous patients related to their atypical roentgenologic manifestations and their increased negative Mantoux tests and negative sputum, which were mainly due to decreased immunologic responsiveness increasing with age.

UR - http://www.scopus.com/inward/record.url?scp=0021035577&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021035577&partnerID=8YFLogxK

U2 - 10.11400/kekkaku1923.58.427

DO - 10.11400/kekkaku1923.58.427

M3 - Article

C2 - 6663960

AN - SCOPUS:0021035577

VL - 58

SP - 427

EP - 433

JO - Kekkaku

JF - Kekkaku

SN - 0022-9776

IS - 8

ER -