The key role of exudative lesions and their encapsulation: lessons learned from the pathology of human pulmonary tuberculosis

摘要: A review of the pathology human pulmonary TB cases at different stages evolution in pre-antibiotic era suggests that neutrophils play an instrumental role progression towards active TB. This is determined by type lesion generated. Thus exudative lesions, which are major cell type, both triggered and induce local high bacillary load, tend to enlarge progress liquefaction cavitation. In contrast, proliferative lesions low loads, mainly comprise epithelioid cells fibroblasts fibrose, encapsulate calcify, thus controlling infection. Infection upper lobes key for two main reasons, namely poor breathing amplitude, allows accumulation, mechanical stress interlobular septae (which enclose secondary lobes) submitted, hampers their ability lesions. Overall, progressing factors can be defined as internal (exudative lesion, bronchogenous dissemination, coalescence lesions), with lympho-haematological dissemination playing a very limited role, or external (exogenous reinfection). Abrogating include control load encapsulation process, directed septae. The age extent disease depend on quality speed liquefy disseminate bronchially, volume slough, amount distribution sloughing debris dispersed.