From Big Medical Encyclopedia


(the synonym mennngoentsefalit tuberku-

lezny) — the meningitis caused by mycobacteria of tuberculosis, which is characterized by formation of miliary hillocks on a soft meninx, hl. obr. in the field of an optic chiasm — see Meningitis, Tuberculosis vnelegochiy, a meningeal tuberculosis and the central nervous system. TUBERKA LYOM (Latin tuberculum a hillock + - Osh; synonym: a huge tubercle, a caseoma, a solitary tubercle) — the pathological education representing the roundish, accurately outlined center consisting of dense caseous masses and separated from the surrounding, usually not struck fabric by the thin capsule. Most often T. it is found in lungs, is more rare in kidneys and a brain. The term is entered into 1938 Mr. by Derchaydomi Toussaint (G. Derscheid, P. Tous-saint).

Sizes T. a lung vary from 1,5 to 5 cm in the diameter and more. T. are more often single, but can be multiple, are located under a pleura in upper shares of lungs.

JPuc. 1. Macrodrug of an upper lung lobe with a solitary homogeneous tuberculoma on a section (it is specified by an arrow).

T. subdivide on eolitarny with a homogeneous caseous masses (homogeneous, fig. 1) or layered caseous masses (layered, fig. 2), and also conglomerate, consisting of the merged caseous centers. Solitary layered T meet more often., in to-rykh concentric layers of caseous masses are divided by layers of connecting fabric that indicates a number of the consecutive flashes of inflammatory process which are replaced by its zatikhaniye.

T develop. as a result of encapsulation of the large centers of infiltrative tuberculosis (solitary homogeneous T.), at merge and the general encapsulation of group of smaller caseous centers (conglomerate T.) or at perifocal inflammatory growth of one-two small tubercular ochazhok forming a kernel

of Fig. 2. The Gistotopografichesky cut of tissue of lung with a solitary layered tuberculoma (it is specified by an arrow).

such solitary layered tuberculoma.

T. develops against the background of rather high resistance of an organism to tuberculosis. I. V. Davydovsky called tuberculomas «immunogen-nymi the centers» since there are they as the allergic and at the same time immunogene centers while sooner or later there does not occur failure of immunity. Probably therefore tuberculomas come to light accidentally at preventive fluorographic or radiological inspection more often.

Emergence of T.

the wedge, forms of tuberculosis demonstrates development by the person (see), the wedge, manifestations to-rogo can be absent for a long time. At the same time T. remains stable or even increases in volume (solitary layered T.). At disintegration of T. the cavity (see) and T is formed. becomes a source of bronchogenic dissimination and active tubercular process. Klein figuratively compares a tuberculoma, edges clinically often proceeds nezakhmetno, with a volcano, always ready to eruption.

Diagnosis, treatment, forecast and prevention of T. a lung — see Tuberkulez of a respiratory organs, T. a brain — see the Brain, T. kidneys — see Tuberkulez extra pulmonary.

Bibliography: Averbakh M. M. Tuber-

of a kuloma of a lung, M., 1969, bibliogr.,

Rabukhin A. E. Tuberkulez of a respiratory organs at adults, M., 1976; F i p-g e of 1 n d A. and. M at d 1 i 1 F. Tuber-culomy plic, Praha, I960, bibliogr.

M. M. Averbakh.