The pulmonary tuberculous lesion in North India: a study in medico-legal autopsies. I. Incidence, nature, and evolution.

An anatomic study of tuberculous lesions of the lung was carried out in 1,680 medico-legal autopsy cases in Delhi. All age groups, with the exception of children younger than ten, and both sexes were adequately represented in the series. Active pulmonary lesions were encountered in 17.0 per cent of the cases. Of these, approximately one-half were fibrocaseous lesions and the remainder, small or large nodules. The small nodules showed characteristic morphologic features, with low-grade smoldering activity and attempts at healing occurring simultaneously. The relationship between the different types of lesions, their evolution, and the importance of the small active nodule are discussed. Histologic demonstration of acid-fast bacilli was easier and more frequently achieved in fibrocaseous tuberculosis than in the nodular varieties. In fibrocaseous and large nodular lesions, acid-fast bacilli were identified as frequently in tissue sections as by microbiologic techniques. The importance of this finding in the...