Type:
Educational Exhibit
Keywords:
Thorax, Lung, Respiratory system, Conventional radiography, CT, CT-High Resolution, Diagnostic procedure, Treatment effects, Pathology, Cavitation
Authors:
C. S. Rizzo1, A. Zanfardini2, E. P. Eyheremendy2; 1Ciudad Autonoma de Buenos Aires/AR, 2Buenos Aires/AR
DOI:
10.1594/ecr2018/C-0374
Findings and procedure details
Thoracic findings of primary and postprimary tuberculosis will be revised in this section.
Typical lesions will be depicted in chest radiographs,
conventional computed tomography and high-resolution computed tomography.
Less frequent imaging features will also be described.
Primary TB
Typical thoracic lesions in primary TB include lymphadenopathy,
pulmonary consolidation,
and pleural effusion (Figures 4-12).
Plain chest X-rays easily depict consolidations and pleural effusion.
However,
subtle consolidations may require a high resolution CT scan to certify alveolar involvement.
An enlarged mediastinum and/or prominent lung hila are usually associated with lymphadenopathy,
suspected in X-rays and generally confirmed in CT.
Postprimary TB
Cavities,
pulmonary consolidation and centrilobular nodules are usual findings in postprimary tuberculosis.
As in primary TB,
chest X-rays are widely used and yield useful information; CT scans show excelent results in lesion characterization and extension (Figures 13-14).
Both tree-in-bud pattern and miliary disease are examples of hematogenous dissemination,
while most cavities indicate bronchogenic spreading (Figures 15-18).
Less frequent lesions include paquipleuritis and lobar atelectasis.
Paquipleuritis is the diffuse thickening of the pleura due to chronic inflammation by purulent TB.
Bronchial compression/obstruction caused by a tuberculotic lymph node may produce lobar atelectasis (Figures 19-22).