Changes in pulmonary function in patients with lung tuberculoma

The lung tuberculoma (LT) is capsulated caseous focus. If LT is progressing and prolong therapy does not give any results, the surgical treatment will be shown. In these cases lung resection may be from the minimal removal of lung tissue to lobectomy. So evaluation an adequate respiratory reserve is very important, but often these patients were examined only by spirometry. Aim: To evaluate changes of pulmonary function in patients with LT. Methods: We have observed 28 patients with LT (16M/12F; 32±2 yrs). All patients underwent Spirometry, Bodyplethysmography, measurement of CO Diffusion capacity (DL CO ), High resolution computed tomography and 10 patients from them underwent Perfusion scintigraphy (PS). Spearman correlation coefficient of DL CO with the age of smoking and maximal diameter of tuberculoma were analyzed. Results: There were mild obstructive disorders in 10 patients and decrease of DL CO from mild to significant in all patients. There were correlations DL CO and the age of smoking (-0,48; p<0,01) and maximal diameter of tuberculoma (-0,37; p<0,05). To assess the influence of the fairly localised specific lesion on DL CO we examined 18 patients without signs of ventilation disorders, non-smokers or of the age of smoking less 5 pack-years. There was significant correlation DL CO with maximal diameter of tuberculoma (-0.43; p<0,05) but not significant with the age of smoking (-0,28; p<0,26). PS had shown decrease of lung capillary blood flow in zones exceeding tuberculoma focus. Conclusion: Patients with LT even without airways disorders had decrease of DL CO . It may be connected with defeat of lung capillary blood flow. This fact should be taken into account before the lung resection in patients with LT.