Spots on the lungs treatment. Darkening on an x-ray. How to treat tuberculosis - main principles

Hello! During fluorography, a darkening was discovered in the left lung. There are no symptoms, no pain, no cough, no weight loss, no sweating, nothing. Direct and lateral X-rays confirmed the presence of darkening in the left lung. The doctor prescribed treatment for pneumonia. After taking antibiotics for 10 days, there was no change. A repeat x-ray again showed the same spot. They sent me to the anti-tuberculosis dispensary. Having undergone an examination (tomogram, blood tests, sputum tests, Diaskintest) accurate diagnosis I can't deliver. The tests are all good. with the exception of increased SOE - 20. Sputum tests are negative. The tomogram shows a round spot. Diaskintest showed papule 25, apparently some kind of inflammatory process is going on in the body. Yes, I also had a consultation with a cockroach surgeon, he recommended additional examination in the cockroach department and an operation to remove this neoplasm of unknown origin. The phthisiatrician prescribed me a trial treatment for... tuberculosis. Appeared side effects literally from the second day of treatment (pain and numbness in the arm, dizziness and almost fainting, pain in the pancreas, constant nausea). Then I doubt it, is it possible to prescribe treatment blindly? Either from pneumonia or from tuberculosis. Where can I get qualified help in diagnosis and treatment? I live in Primorsky Krai.

Hello!
Darkening in the lung indicates compaction of the lung tissue, and several dozen lung diseases may be accompanied by this symptom and the appearance of single or multiple rounded shadows on radiographs. The most important of these diseases are: acute pneumonia; tuberculosis infiltrate; tuberculoma; primary lung cancer; tumor metastases to the lungs; retentional lung cyst; echinococcus lung; encysted pleurisy; eosinophilic infiltrate; mediastinal cyst; tumor of the mediastinum, etc. Since DIASKINTEST showed a 25 mm papule in you, this indicates a hyperergic reaction, tuberculosis cannot be excluded, since this test does not cause positive reactions in healthy and BCG vaccinated individuals.
To clarify the diagnosis in your case, further examination is necessary: CT scan lungs, and diagnostic bronchoscopy of the lungs. Since all diagnoses are made on the basis of a complex of clinical, laboratory, and radiological data. You can also additionally take tests for tumor markers, although they are not used for primary diagnosis, but can still be useful in the current situation. They do not establish a diagnosis, but they help to further monitor the dynamics of the process; for example, after surgery, their level can be used to monitor the effectiveness of treatment. For oncological processes in the lungs, the following tumor markers are informative: No. 1005 Cancer embryonic antigen, No. 1013 Neuron-specific enolase, No. 1014 SCCA (if squamous cell carcinoma is suspected). These examinations will help the doctor in diagnosing your existing disease.
Regarding the question of where you can get qualified help in diagnosis and treatment, perhaps it will be KKB No. 1 in Vladivostok, where the pulmonology center is located.

With smooth, clear contours of medium intensity - such a conclusion from a radiologist is often found. It reflects infiltrative changes in the lung tissue or “plus shadow” syndrome.

What to do if a white spot is detected on the x-ray

When performing radiography of organs chest or fluorography in a patient with tuberculosis White spot on x-ray reflects either inflammatory lesion lung tissue, or destructive changes in the parenchyma with the formation of abscesses, tubercles, cavities. Right this symptom should be called darkening, since it reflects the characteristics of the passage x-rays through objects and their color display on a radiograph.

Shadow in the photo white also observed with:

• atelectasis;
• exudative pleurisy;
• occupational diseases(silicosis, talcosis, asbestosis).

This syndrome is a sign of many pathological changes in the lungs, but we will consider the most common options.

If stains are found, it is necessary additional research, allowing us to establish the cause of the pathology. For these purposes, a radiologist may prescribe an X-ray examination in additional projections or perform layer-by-layer computed tomography or magnetic resonance imaging.

What does a spot look like on an x-ray with pneumonia?

In pneumonia, the spot on the x-ray image has a length depending on the size of the lesion in the pulmonary parenchyma:

• limited – up to 3 cm in diameter;
• segmental – within a segment;
• subtotal – the entire field, with the exception of the tops;
• total.

Pneumonia - inflammatory disease, in which the alveolar tissue is affected with the accumulation of fluid in the acini. Pathogenesis forms a specific x-ray picture of the disease.

The white spot with pneumonia has fuzzy, blurred contours. Its intensity can be low or high, depending on the characteristics of the exudate (inflammatory fluid in the lumen of the alveoli). A path from the root approaches the site of its localization due to lymphangitis.

Atelectasis of the lung or x-ray semiotics of triangular spots on the image

Atelectasis of the lung– a disease accompanied by the collapse of a segment, lobe or lung tissue completely against the background of cessation of bronchial ventilation. Radiologically, such changes are called limited darkening, since they do not extend beyond the segment or subsegment and have triangular shape.

How to identify atelectasis in an image:

• the size of the spot coincides with the size of the changed segment;
• triangular darkening in the lungs can be seen in frontal and lateral projections;
• during inhalation photographs the size of the spot does not increase;
• the narrow end of the triangular shadow is directed towards the root;
• Holtzknecht-Jacobson symptoms are observed during fluoroscopy (suction of the mediastinum towards the lesion during exhalation).

The morphological substrate of the pathology is the accumulation of infiltrative fluid in the alveoli, infiltration of lung tissue, and tumor growth in the pulmonary parenchyma.

Spontaneous atelectasis occurs in 1-3% of patients due to a defect in surfactant (the substance that forms the framework of the alveoli).

Limited dimming when the lungs collapse, it requires knowledge of the segmental structure of the lungs, since it reflects atelectasis of a certain segment. By establishing the topography of the shadow, the doctor can guess which bronchus is affected. The substrate of formation (infiltrate, additional tissue, exudate) is almost impossible to determine on the basis of a radiograph.

What does a white spot mean in a picture of tuberculosis?

A focal spot on a chest x-ray indicates the infiltrative stage of the disease, when mycobacteria begin to infect the lung tissue. In this case, the x-ray shows a path to the root from the side of the lesion (due to lymphangitis). Such radiological symptoms are called “primary tuberculosis focus”.

Multiple small disseminated shadows on both sides indicate miliary tuberculosis.

A single large shadow with a cavity inside (clearance) and a fluid level - an abscess formed against the background of destruction of the lung parenchyma - “ring shadow” syndrome.

A spot on an X-ray of the lungs in the projection of the pulmonary fields reflects a pathological process, the causes of which should be established by additional research.

Timely detection of any pathological process affects the effectiveness of ongoing therapeutic measures. In this regard, currently medical institutions(both public and private) put forward requirements for the patient to undergo a mandatory annual examination. One of these diagnostic procedures is fluorography - it is carried out to detect tuberculosis and lung cancer.

Early diagnosis of these diseases increases the likelihood of a positive outcome of treatment. Even in the conditions of the modern medical industry, X-ray examination of the chest organs is considered a simple and informative technique. To identify pulmonary pathology, fluorography is most often used - a screening and publicly available method.

Sometimes the test result contains information that a spot was found on the lungs. This causes concern for a qualified specialist and particular concern for the patient himself. The first question he asks the attending physician: “What is this phenomenon and what is its cause?”

There are many reasons that cause darkening in the lungs on fluorography. In this article we will provide detailed information about what a standard fluorography image looks like, what factors provoke the appearance of dark or white spots on it, and we will also help our readers understand the situation of detecting darkening on the lungs.

X-ray imaging features

An x-ray is a negative image of the object under study on a special film, obtained using ionizing radiation, which has the ability to penetrate various tissues and biological environments of the human body. A classic fluorography image reflects the reverse correspondence of shadows: light areas indicate the state of organs with the most dense structure, dark areas indicate tissues with a minimum density that easily transmit x-rays.

When studying, the radiologist relies on strict adherence to standards - in the picture healthy lungs right part looks wide and short, the left one looks narrow. Both areas must contain a large volume of air, not interfere with the passage of X-rays, and appear transparent on a fluorographic image.

Reasons for dimming

Origin this phenomenon may be different, an accurate interpretation can only be given qualified specialist. However, nevertheless, I would like to highlight the main factors causing dark areas in the image:

• hearth active infection caused by Koch's bacillus (the causative agent of tuberculosis);
• structural changes in lung tissue due to an infectious-inflammatory process or traumatic injury;
• consequences addiction– smoking;
• filling of the pleural sinus with pathological fluid (effusion);
• respiratory system diseases;
• tumor-like formations;
• presence of a foreign object in the lungs;
• purulent-destructive limited process (abscess pneumonia).

The value of the darkening depends on its location - on the left or right lung, in the upper or lower part of it; to establish the exact causes of the spot, consultation with a qualified medical specialist is necessary

Digital codes for describing fluorogram data

Today, many clinical diagnostic centers most often use a safer and more effective x-ray method - digital fluorography. Compared to the analogue method, it has more best quality images and has a lower radiation dose. Its result indicates a code with an encrypted specific pathological process.

Types of shading

If fluorography shows the presence of a dark spot on the projection of the lungs, this does not necessarily mean that the patient is suffering from a tuberculosis infection or an oncological process. Although, of course, darkening on fluorography may indicate the presence of a serious disease. That is why, before you put final diagnosis, the attending physician carefully examines the shape and external differences of dark spots in the lungs on an x-ray.

They are usually classified according to several main types:

• Focal - the presence of small spots, no more than 1 cm in diameter. Characteristic of inflammatory reactions, formation of tumor-like formations, disorder blood vessels. Patients complain of headache, weakness, chest tightness, fever, poor appetite, intense cough.
• Segmental - the spot has a certain (most often triangular) shape; they can be single or numerous. The presence of a single segmental shadow is observed in benign or malignant endobronchial neoplasms, foreign body in mild, mechanical damage to the parenchyma. Several segmental darkening is characteristic of pneumonia, tuberculosis, bronchial stenosis, pleural effusion.
• Focus – highly visible pathological formations clear outline different shapes. Points to chronic stage pulmonary disease.
• Lobar – characterizes purulent formations in the lung tissue, bronchiectasis, cirrhosis of the lungs.
• Indeterminate - a noticeable blurry dark spot of unknown shape and size. Most often caused by the proliferation of staphylococci, which provoke pneumonia - a very common primary or secondary inflammatory disease of bronchial or pulmonary tissues. Patients complain about high temperature, headache, general weakness, malaise. In some cases, a dark spot indeterminate form observed when pulmonary infarction, tumor formation, pulmonary edema, pleural effusion, hemorrhage.
• With the presence of fluid accumulation - evidence pulmonary edema. The emergence of this pathological condition characteristic of an increase in pressure in the pulmonary vessels or a decrease in the concentration of protein cells in the blood. Due to effusion, the lungs cannot fully perform their function.

Long-term smoking provokes the occurrence of infiltration syndrome - excessive penetration and accumulation of fluid containing various chemical and biological substances in the alveoli. active substances, cellular elements

Pulmonary edema is divided into two types: hydrostatic, caused by an increase in pressure in the blood vessels (observed in pathologies of cardio-vascular system), and membranous, caused by damage to the lung tissue by toxic substances that penetrated the bloodstream.

What to do?

The most correct decision when a spot on the lung is detected on fluorography is not to panic! To accurately diagnose the disease and conduct rational treatment, the patient is prescribed a set of diagnostic procedures, consisting of:

• from general clinical and biochemical research blood and urine;
• fluoroscopy in direct and lateral projection;
• tuberculin test - Diaskin test;
• bacteriological culture of sputum;
• broncho- or tracheoscopy – endoscopic examination respiratory organs;
• computed tomography of the lungs.

At the end of the above information, I would like to add that there may be errors when interpreting the results of fluorography. However, the diagnostic technique itself cannot be considered ineffective. Using this quick and inexpensive method, which is used for medical examination of the population, practitioners successfully identify many serious pathological processes and start treatment in a timely manner.

Every Russian citizen knows that annual preventive medical examinations are a mandatory procedure. One of the most important examinations- , which allows you to detect various diseases on early stages their development. Alarm bells for doctors it is a pathological darkening of these organs.

Darkening in the photo of the lungs.

There are many reasons that lead to the occurrence of such darkening, therefore, to determine them as correctly as possible, experts do not disdain other examinations.

After all, certain darkening is just an indicator that inflammation (of any nature) is occurring in the body. Why does darkening appear in the picture? To answer this question You need to study this topic carefully.

Key Features

In most situations pulmonary diseases accompanied by the appearance of compactions. Such problems occur due to a decrease in diameter or blockage of air passages at specific locations on the surface of the lung, and radiologists see dark spots on the fluorogram.

Symptoms of this kind are confirmation of the occurrence or development of pathologies in the lungs themselves or surrounding cells.

Shadows indicating pulmonary diseases often have different intensities, clarity and dimensions. Such areas are evidence of the following health problems:

• Inflammation and tissue compaction;
• nodular neoplasms (tumors);
• clogged air passages;
• development of tuberculosis processes;
• fluid filling of the lung pleura (the layer of membrane that covers and protects every organ in the sternum);
• inflammation of the pleura;
• pustular abscesses.

Fluorographic images often contain dark spots manifested due to defects of any organ behind the ribs. Such symptoms are confirmation of such problems:

1. Enlarged lymph nodes.
2. Tumors on the vertebrae/ribs.
3. Diseases of the esophagus, etc.

Types and description of dark spots

The type of pathological damage to the tissues of the respiratory system greatly influences the way the shadows are located, their dimensions and geometry. Based on this, all dark spots on fluorograms can be:

• Focal;
• formless;
• focal;
• liquid;
• segmental;
• share type.

Let us consider in detail each type of such shadows.

Focal shadows

This type of dark spots are small nodular areas up to 10 mm in size. Usually they manifest themselves in the event of any inflammation or problems with blood vessels. Such darkening is often a sign of the onset of the development of any pulmonary diseases.

Based on one fluorogram, it is impossible to determine exactly what the reasons for the appearance of lesions and their nature are, so doctors always prescribe patients to additionally undergo a CT scan or radiography. It is also advisable to conduct laboratory tests, during which the indicators and contents of the mucous membrane, urine, etc. are examined.

In situations where, when identifying focal opacities in a patient elevated temperature, general malaise of the body, headache, incessant coughing attacks, severe chest pain, there is high probability diseases of bronchopneumonia.

A focal shadow on an X-ray of the lungs, which indicates internal bleeding.

When the results of a blood test do not confirm the presence of any abnormalities, development is possible.

The main symptoms of this disease are decreased appetite, malaise, causeless dry cough, frequent irritability, strong pain in the sternum. If this diagnosis is suspected, doctors prescribe a series of studies.

Another common disease in focal darkening is a pulmonary infarction, in which thrombophlebitis appears in the legs, pathology of the heart muscle, . The last problem that can be discussed in the presence of a focal shadow on a fluorographic image is peripheral cancer.

Single cases of focal shadow on a fluorogram have round shape, and their size often exceeds 10-12 mm. Such darkening in the lungs is considered a sign of inflammation, which manifests itself due to the occurrence of such diseases:

• Inflammation of the lung;
• local effusions (water channels in the lungs expand);
• eosinophilic infiltrates - this disease is accompanied by mechanical lesions of the lungs, bronchial asthma;
• abscesses.

Focal shadow in the photo.

One of the most rare causes the appearance of such shadows on fluorograms is the use of highly targeted, potent medications, availability of purchased or congenital cysts, which are filled with liquids/gases.

This type of darkening can also indicate problems with tumors:

• Benign (fibroma, adenoma, lipoma, hamartochondroma);
• malignant (metastasis, sarcoma).

Often round dark spots confirm the presence calluses which are caused by rib fractures. Doctors must take this fact into account when deciphering film fluorograms.

Segmental spots

Dark spots on fluorograms can be distributed as separate segments of any diameter/shape (usually triangular). There can be up to 10 such dark spots on a lung, and doctors make a diagnosis of diseases based on a comprehensive examination. The appearance of single spots on the lung is usually considered a symptom of the following diseases:

• Endobronchial tumor;
• foreign bodies, mechanical damage lung tissues.

In the case of clear viewing of several darkened areas on film fluorograms, we can talk about the following problems:

• Chronic pneumonia or acute form this disease;
• tuberculous inflammation;
• centralized oncology;
• central bronchial constrictions;
• concentration of any fluids in one place of the pleural tissue;
• malignant metastases.

Shapeless spots

Fluorograms often contain darkened spots that are not shaped like other species. Usually their appearance is not similar to certain geometric shapes, and there are no clear boundaries of the shadows. In most cases, such lung pathologies confirm the symptoms of staphylococcal pneumonia. This problem can develop in the following forms:

1. Primary. This disease manifests itself in the presence of inflammation in the lung/bronchus.
2. Secondary. This form develops as a result of hematogenous infection from a purulent focus (due to osteomyelitis, adnexitis or other similar diseases). IN last decade the secondary form of staphylococcal pneumonia has begun to spread much faster, so people must undergo fluorography every year to detect this disease at an early stage.

Dark spots of this kind can often occur due to edema of the lung tissue, pulmonary effusions of blood, tumor-like neoplasms, concentration of fluids inside the pleura in one place, and the presence of another disease that can be accurately determined using laboratory testing. When similar diseases Patients often experience fever, cough, malaise, and headaches.

Share shadows

In the case of lobar darkening in the lungs, their contours are clearly visible in fluorogram images. Usually they differ in shape by their convexity, concavity, straightness, etc. Lobar darkened spots usually confirm that people have any chronic pulmonary diseases, which are easily determined using computed tomography.

Most often, the lobar spot is a confirmation of the development of cirrhosis, bronchiectasis, and the appearance of purulent cavity. Any of the indicated pathologies on a CT image is very different from cancerous tumor, therefore, it is necessary to accurately determine malignant neoplasms only if a person has bronchial obstruction due to inflammatory or scar formations.

Darkened areas filled with liquids

The image shows fluid in the lungs.

This type of darkening in the lungs on fluorograms usually indicates developing edema. Such problems may arise due to high blood pressure inside the pulmonary vessels or due to a decrease in the content of protein substances in the blood. The presence of fluid in the lungs is an obstacle to the proper functioning of this organ.

Pulmonary edema occurs:

• Hydrostatic. These problems arise due to high pressure in the blood vessels, so the fluid leaves the bloodstream and penetrates the alveolar areas (the extreme points of the respiratory system), gradually filling the lung. Similar pathology most often occurs due to ischemia or other chronic problems heart muscle.
• Membranous. The cause of these edemas is the strong impact of toxic substances that damage the lining of the alveoli and then exit the blood vessels of the lung.

The correctness of diagnosis is greatly influenced by qualification level, practical skills and theoretical knowledge radiologists studying and describing fluorograms.

The equipment used to perform the X-ray examination also plays a very important role. It is for this reason that it is advisable to contact reliable clinics where real professionals and experts in their field work, who recognize each type of darkening in the lungs.

The list of mandatory annual medical examination procedures includes a fluorographic examination of the lungs. This helps to identify initial stages diseases that may later turn out to be serious. An indicator that you should immediately contact a specialist is the identification of a spot on the lungs when viewing fluorography.

What does darkening in the lungs mean?

Before you get an appointment with a doctor, a patient who has developed such unpleasant symptom, wondering what darkening in the lungs means. Without a doubt this is a worrying sign deterioration of your health, but do not immediately despair. There are many reasons for the appearance of darkening on fluorography in the lungs, so in order to make a final diagnosis, the general practitioner must prescribe additional tests that could reveal other symptoms of a particular disease:

1. Most often, darkening in the lungs shows inflammatory processes and tissue compaction, which can be caused by a number of infectious diseases.
2. Dark spots can also manifest themselves due to the appearance of tumor nodes, which is even more unpleasant. In this case, fluorography becomes the only detection of oncology, so doctors strongly recommend undergoing it regularly.
3. In addition, darkening of the lungs may indicate the development of tuberculosis, which is why prolonged cough, which cannot be treated with conventional expectorants, the doctor should prescribe fluorography, regardless of how long ago you had it.
4. If an area that is impenetrable to air appears in the image, a darkening will also appear. But the symptom can also appear when such problems appear with the pleura (the membrane that covers the lungs and chest cavity), such as fluid in the pleura, inflammation or purulent abscesses.

Also, dark spots on the lungs during fluorography can be a signal of problems with other organs, for example:

• lymph nodes - inflammation;
• ribs and spine - neoplasms;
• esophagus – expansion and more.

But, oddly enough, a dark spot in the picture can indicate not only the development or neglect of a serious illness, but also the consequences of pneumonia or bronchitis. These diseases leave behind nodules on lung tissues, which do not cause any harm, and subsequently completely dissolve, so you should not be afraid of them.

Blackouts are divided by shape and quantity. Single segments indicate benign or malignant tumors. If there are many spots on the picture, then they can indicate several pathologies:

• tuberculosis;
• central cancer;
• narrowing of the central bronchus;
• accumulation of fluid in the pleura;
• malignant formations in other internal organs.

The location of the segments is also important. So, if the image reveals darkening of the apex of the lung, then this may indicate, but the doctor should recommend, in addition to additional tests, which are prescribed when a disease is suspected, repeated fluorography.

If there is a spot in the photo with unclear borders, this may indicate pneumonia. This manifestation in the picture is usually accompanied by fever, headaches and weakness. But sometimes pneumonia can occur without high readings on the thermometer.