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Response of pulmonary tuberculomas to anti-tuberculous treatment

Division of Respiratory and Critical Care Medicine, Dept of Internal Medicine and Lung Institute of Medical Research Centre, Seoul National University College of Medicine, Seoul, Republic of Korea

CORRESPONDENCE: J-J. Yim, Division of Respiratory and Critical Care Medicine, Dept of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, Republic of Korea. Fax: 82 27629662. E-mail: yimjj@snu.ac.kr

Keywords: anti-tuberculous treatment, pulmonary tuberculoma, pulmonary tuberculosis

Received: July 28, 2003
Accepted November 25, 2003

This study was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (00-PJ1-PG1-CH03-0001).

Pulmonary tuberculomas are well-circumscribed masses caused by Mycobacterium tuberculosis. However, the response of tuberculomas to anti-tuberculous (TB) treatment has not been well defined as yet.

The response of pulmonary tuberculomas to anti-TB treatment was retrospectively reviewed in 45 patients diagnosed between January 1997 and December 2001. The areas of pulmonary tuberculomas were estimated by calculating products of the longest and their perpendicular short diameters on chest radiographs. The response to anti-TB treatment was categorised as "decreased" (>25% reduction in area versus its initial area), "increased" (>25% increase) and "no change" (the remainder).

The mean of treatment duration was 11.5±3.6 months. Three months after treatment, 18 patients (40.0%) were categorised as decreased, 25 (55.6%) as no change and two (4.4%) as increased. Twelve months after treatment, out of 42 patients available for chest radiographs, 32 patients (76.2%) were categorised as decreased, nine (21.4%) as no change and one patient (2.4%) as increased. At the last follow-up (mean follow-up 27.0±10.2 months), 37 patients (82.2%) were categorised as decreased.

The majority of pulmonary tuberculomas were decreased by anti-tuberculosis treatment during and even after treatment, although a transient enlargement during the early period of treatment was observed infrequently.