[Features of morphological reactions in caseous pneumonia]

The morphological features of caseous pneumonia (CP) were studied in 90 patients aged 20-54 years by using specimens obtained at autopsy and surgery at the Central Research Institute of Therapy, Russian Academy of Medical Sciences and Moscow Clinical Tuberculosis Hospital No. 7. Thirty patients died from CP, 30 were operated on for CP. A matched group of 30 patients was operated on for fibrocavernous pulmonary tuberculosis (FCPT). Of the 30 patients operated on for CP, the process was classified as an individual nosological entity in 19 patients and as a complication due to FCPT in 11 patients. Out of the 30 deceased, CP was as an individual nosological entity in 17 patients and it complicated acute FCPT in 13 patients. Morphological (light and electron microscopy) and immunomorphological studies revealed the specific features of CP, which distinguished it from other forms of pulmonary tuberculosis. These included: the fulminant course and dissemination of lung tissue lesion, which is association with the appearance of intravascular blood coagulation and lung infarction; 2) development of immunodeficiency in the presence of autoallergy to the basilar membrane of lung vessels, macrophageal and lymphocytic dysfunctions; 3) extensive cell dystrophy of the air-blood barrier even in the intact portions of the lung; 4) hepatic dysfunction due to extensive dystrophy to the extent of hepatocytic micronecroses and dyscirculatory disorders.