[A difficult case of the differential diagnosis of focal infiltrative lung changes in phthisiatric practice].

Errors occur rather commonly in the differential diagnosis of respiratory diseases accompanied by X-ray lung tissue changes as foci and infiltration. Infiltrative and disseminated pulmonary tuberculosis, lung cancer, and pneumonia constitute a high proportion among the detected concurrent lung diseases. The rate of diagnostic discordance for these lung abnormalities accounts for more than 30%; and the diagnosis period for an infiltrative lung process lasts 2­3 weeks in 20% of cases and above 1­3 months in 80%. In particular, clinicians are faced with great difficulties in diagnosing aspiration pneumonia; this is due to that its X-ray manifestations are not purely specific and they are characterized by the parenchymal (alveolar) infiltration of lung tissue with a varying extent of lung inflammation. This paper describes a clinical case of a patient with salivary gland adenocarcinoma and focal infiltrative lung changes. Diagnostic difficulties have emerged in establishing the genesis of the changes in the lung.

[Differential diagnosis of systemic vasculitis and tuberculosis].

Microbiology, X-ray study, and bronchoscopy, including the examination of bronchoalveolar lavage and histology of thransbronchial lung biopsy specimens have proven to be of the greatest informative value in the differential diagnosis of different forms of systemic vasculitis and tuberculosis in 52 patients. Focal pulmonary tuberculosis was detected in the phase of S(II) infiltration on the right in a patient with rheumatic arthritis; Mycobacterium tuberculosis was bacterioscopically detected. The patient underwent specific antituberculous therapy that provided beneficial effects.