We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

The Value of Roentgenographic and Fiberbronchoscopic Findings in Predicting Outcome of Adults With Lower Lung Field Tuberculosis

Shi-Chuan Chang, MD, PhD; Pui-Yuen Lee, MD; Reury-Perng Perng, MD, PhD
Arch Intern Med. 1991;151(8):1581-1583. doi:10.1001/archinte.1991.00400080079014.
Text Size: A A A
Published online


Proper antituberculosis chemotherapy may not prevent occurrence or progression of endobronchial involvement in patients with pulmonary tuberculosis. We previously reported a higher incidence of endobronchial involvement in adults with lower lung field tuberculosis (LLFTB). We evaluated the value of roentgenographic and fiberbronchoscopic findings in predicting the outcome of adults with LLFTB after 9 months of antituberculosis chemotherapy. The most common change on chest roentgenograms among 101 patients with LLFTB was consolidation, followed by cavitary lesion, lung collapse, and solitary mass. Intrathoracic lymphadenopathy (hilar and/or mediastinal lymphadenopathy) was found in 12 cases. Sputum smear for acidfast bacilli was positive in 64 patients, and sputum culture for tuberculous bacilli was positive in 37 of 50 patients. Endobronchial involvement was found in 45 of 63 patients who underwent fiberbronchoscopic examination. Of these 45,18 had ulcerative granuloma, 12 had fibrostenosis, eight had submucosal infiltration, and seven had mucosal redness and swelling. A higher incidence of endobronchial involvement was found in the patients with LLFTB when they presented with roentgenographic findings of pulmonary consolidation, lung collapse, or associated intrathoracic lymphadenopathy. The outcome seemed unfavorable in the patients with LLFTB who presented with roentgenographic findings of lung collapse or pulmonary consolidation, or in those who presented with fiberbronchoscopic findings of fibrostenosis or ulcerative granuloma. Our results show that roentgenographic and fiberbronchoscopic findings are of value in predicting outcome of patients with LLFTB. With proper antituberculosis chemotherapy and close follow-up, fiberbronchoscopy may be clinically indicated in patients with LLFTB to assess the presence and severity of endobronchial involvement. Early surgical intervention can be considered in those with severe endobronchial involvement before serious sequelae occur.

(Arch Intern Med. 1991;151:1581-1583)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

6 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.