Pathomorphological Changes in the Lungs in Patients with Comorbidity Pulmonary Tuberculosis and Diabetes Mellitus

Objective — to examine the pathomorphological changes in lung tissue in patients with pulmonary tuberculosis and diabetes mellitus. Materials and methods. A prospective pathomorphological study was conducted of 60 cases of death of patients who died from various causes, in which pulmonary tuberculosis and type II diabetes appeared as the main disease in the final clinical and patho-anatomical diagnoses.The patients were divided into three groups, the first subgroup consisted of 20 cases in which a diagnosis of pulmonary tuberculosis was established without pronounced accompanying pathology; the second subgroup included 20 cases of the combined pathology of tuberculosis and type II diabetes; to the third — 20 cases of patients with type II diabetes without tuberculosis. The types of patients of both groups were representative in terms of age and sex.Results and discussion. The results of the pathomorphological examination of the lung tissue of patients with tuberculosis without accompanying diabetes showed that in 90 % of cases the capillaries of the lung parenchyma structure were not changed, except for those areas that were involved in a specific classical tuberculosis inflammation.According to the results of the study of the histological material of the 2nd group, it was established that one of the key pathomorphological changes in the comorbidity of tuberculosis/diabetes is the development of pulmonary microangiopathy, which was characterized by a marked violation of the structure of small blood vessels of the microcirculatory channel of the lungs. Thus, the analysis of autopsy morphological material showed that there is a histological picture of a change in the structure of the capillary channel: zones of complete obliteration of capillaries appear, unevenness of the caliber of microvessels is observed, and the number of functioning capillaries decreases. It was found that in patients of the 3rd group, probably (p < 0.05) 85 % more often compared to 15 % in the 1st group, changes in the alveolar epithelium were observed. Conclusions. Pathomorphological changes in the lungs in patients of the 2nd and 3rd examination groups include microangiopathy, pulmonary fibrosis, degeneration of the alveolar epithelium and, as a result, respiratory tract dysfunction. These changes contribute to the development of serious complications and require special attention in the treatment of patients with TB/DM co-infection to prevent further deterioration of lung tissue.