Tuberculosis: Infiltrating systems and lives; Unusual presentations from a Radiologist's point of view

Congress:

ECR 2020

Poster Number:

C-11908

Type:

Educational Exhibit

Keywords:

Retrospective, Infection, Abscess, Diagnostic procedure, MR, CT, Musculoskeletal system, Head and neck, Abdomen, Imaging Informatics, Observational, Performed at one institution

Authors:

B. GUPTA¹, R. H. Sawant², P. Patil³, T. Vu⁴, M. MANMOHAN¹; ¹Mumbai, Maharashtra/IN, ²Navi Mumbai, Maharashtra/IN, ³Mumbai/IN, ⁴Navi Mumbai/IN

DOI:

10.26044/ecr2020/C-11908

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-11908

Fig. 7: GIST with overlying tubercular abscess (proven through Immunohistochemistry and...

Fig. 8: Peripherally enhancing lesion with overlying cold abscess (thick walls and...

Fig. 9: Coronal images showing chronic sclerosis peritonitis secondary to tuberculosis

Fig. 10: Sagittal images demonstrating peritonitis with clumped bowel loops and free...

Learning objectives

To evaluate/characterize the unique, multifaceted presentation of tuberculosis in various tissues of the body, and the associated rare imaging features. Describe lesions tuberculosismimics.

Background

Tuberculosis is a multi-systemic disease with varied presentations, some usual, while others baffling, making it hard to diagnose. CT scan and MRI scans are being employed to understand the spread of the disease, assess extensions and invasions, and characterise the lesions. Even though there was an initial decline in the incidence of tuberculosis, there has been a significant resurgence due to acquired immunodeficiency syndrome and increasing number of drug-resistant strains ofMycobacteriumtuberculosis(1). With the capacity for widespread infiltration, theMycobacteriumhas been demonstrated in samples from almost every...

Findings and procedure details

Pulmonary tuberculosis: Peri-lymphatic spread of tuberculosis The nodules are subpleural, occurring along fissures, interlobular septa and adjacent to bronchovascular bundles. There is lower incidence of positive acid-fast bacilli smears, consolidation and cavitation in patients with perilymphatic spread of tuberculosis. Imaging findings: Cluster sign: Clustered perilymphatic micro-nodules Galaxy sign: Multifocal ill-defined areas of clustered perilymphatic micro-nodules with or without central coalesces, with few of the nodules showing hypodense areas within. Presence of galaxy clusters in the superior segments of bilateral lower lobes clinches the diagnosis. Few...

Conclusion

Even after years of battling tuberculosis, it remains a major health problem in both developing and industrialized countries. However, with early diagnosis and timely initiation of appropriate treatment, morbidity, mortality and further spread can be curtailed.

Personal information and conflict of interest

B. Gupta; Mumbai, MAHARASHTRA/IN - nothing to disclose R. H. Sawant; Navi Mumbai, MAHARASHTRA/IN - nothing to disclose P. Patil; Mumbai/IN - nothing to disclose T. Vu; Navi Mumbai/IN - nothing to disclose M. Manmohan; Mumbai, MAHARASHTRA/IN - nothing to disclose

References

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