The pulmonary resection plays an important role in the management of tuberculosis, especially MDRTB, or non-tuberculous mycobacteriosis. For the satisfactory outcome, pre- and postoperative chemotherapy is mandatory. On the same time, resected specimens should be examined bacteriologically to evaluate preoperative chemotherapy. Acute mycobacterial empyema occurs frequently by the perforation of cavitary lesions, especially with pulmonary NTM. The outcome of such acute and destructive diseases is poor in the case of old age over 70y/o. But without surgical intervention, such difficult condition becomes more miserable. Although mycobacterial mediastinal lymphoadenitis, or osteoarthritis are rare tuberculosis-related disease in Japan, we should keep in mind such rare diseases in ordinary practice.

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