Type:
Educational Exhibit
Keywords:
Infection, Education, Diagnostic procedure, MR, CT, Conventional radiography, Thorax, Mediastinum, Lung, Cavitation, Epidemiology
Authors:
M. F. B. Salomon1, D. Oliveira1, A. ALTOE2, E. Pacheco1, P. GUILHON1, V. Lontra3, P. Antunes1, A. S. A. D. Melo3, A. A. S. M. D. Santos3; 1Niteroi/BR, 2Rio de Janeiro/BR, 3Niterói , Ri/BR
DOI:
10.26044/ecr2019/C-2313
Background
Primary tuberculosis occurs especially in immunosuppressed individuals or children who have not had previous contact with the bacillus and develop the disease in the first infection.
It may present as lymphadenopathy,
consolidation,
atelectasis,
pleural effusion and milliary disease,
with lymph node enlargement being the most common manifestation.
Post-primary tuberculosis usually occurs in adults after reinfection or reactivation of a latent focus.
The lung is the most affected organ.
Besides the pulmonary form,
there are still the pleural,
pericardial,
tuberculous lymphadenopathy,
chest wall,
mammary,
bone,
and Pott's disease.
Pulmonary lesions can be divided into:
- Parenchyma: excavations,
excavated nodules,
centrilobular nodules (tree in bud pattern), random distribution small nodules (miliary pattern),
Halo Sign,
Inverted Halo Sign,
Sarcoid Galaxy Sign,
tuberculomas,
consolidations,
ground-glass attenuation areas,
pulmonary interstitium thickening.
- Airways: tortuous bronchi,
bronchiectasis,
wall thickening and bronchi stenosis.
- Pleural: effusion,
thickening,
empyema,
calcifications and bronchopleural fistula.
Chest wall TB it is a rare manifestation of musculoskeletal tuberculosis.
Excluding the spine,
the rib is the most affected site.
It can also affect the sternum,
the sternum-clavicular joint and soft tissues,
such as the breast.
Bone involvement occurs with erosion and bone destruction,
mass,
or adjacent soft tissues abscess.
Pott's disease affects disc space and adjacent vertebral bodies,
causing anterior collapse (wedge deformity) with evolution to pathological kyphosis of the dorsal spine.
Imaging findings include osteolytic lesions,
areas of sclerosis,
and paravertebral abscess,
which may present as a mediastinal mass.