CT Findings of Pulmonary Tuberculosis Presenting as Segmental Consolidation

Park, Sumi; Hong, Yong Kook; Joo, Suk Hyun; Choe, Kyu Ok; Cho, Sang-Ho

doi:10.1097/00004728-199909000-00019

Cited by 13 publications

(10 citation statements)

References 14 publications

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“…Lymphadenopathy in tuberculous pneumonia patients was uncommon in our study and also in other studies7, 10) and it was different from that of childhood primary TB, in which lymphadenopathy was observed in almost all such patients27). Goussard et al speculated that the pathogenesis of tuberculous pneumonia in children was enlarged tuberculous lymphadenitis that ruptured into the bronchus; the caseous material was aspirated into the affected lobe and the subsequent exudative hypersensitivity reaction to the aspirated tuberculoprotein caused tuberculous pneumonia28).…”

Section: Discussionsupporting

confidence: 44%

“…Tuberculous pneumonia, similar to childhood primary tuberculosis18), is the unusual radiographic finding in adults and this occurs in any site of the lung6, 10) Tuberculosis occurring in the lower lung fields in adult is a frequent characteristics of tuberculous pneumonia19), which is homogeneous segmental or lobar consolidation6, 7). Fever was more common and the duration of symptom until the hospital visit was shorter for tuberculous pneumonia than for cavitary TB.…”

Section: Discussionmentioning

confidence: 99%

“…Goussard et al speculated that the pathogenesis of tuberculous pneumonia in children was enlarged tuberculous lymphadenitis that ruptured into the bronchus; the caseous material was aspirated into the affected lobe and the subsequent exudative hypersensitivity reaction to the aspirated tuberculoprotein caused tuberculous pneumonia28). Tuberculous pneumonia, including that in the lower lung in adults, is frequently associated with endobronchial lesions7, 10) and it is more common in female patients25, 29). In our study, seven non-responders to antibiotic therapy and they had negative sputum AFB smears were examined by bronchofibroscopy, and endobronchial lesion was discovered in six of them.…”

Section: Discussionmentioning

confidence: 99%

“…One of these atypical radiological findings in adult is tuberculous pneumonia that resembles childhood primary TB. The radiographic characteristics of tuberculous pneumonia are homogeneous, segmental or lobar consolidation6, 7) and it occurs in any site of the lung6, 10).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Investigation of Cavitary Tuberculosis and Tuberculous Pneumonia

Lee

Choe

Kim

2006

Korean J Intern Med

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BackgroundThe radiographic characteristics of tuberculous pneumonia in adults are similar to primary tuberculosis that occurs in childhood, and upper lobe cavitary tuberculosis is the hallmark of postprimary tuberculosis. The purpose of this study was to investigate the factors associated with tuberculous pneumonia by making comparison with cavitary tuberculosis.MethodsThe medical records and radiographic findings of patients with cavitary tuberculosis and tuberculous pneumonia, and who were diagnosed between March 2003 and February 2006, were analyzed retrospectively.ResultsForty patients had cavitary tuberculosis and sixteen patients had tuberculous pneumonia. Fever was more frequent for tuberculous pneumonia, whereas hemoptysis was more frequent for cavitary tuberculosis. The duration of symptoms before visiting the hospital was shorter, but the diagnosis after admission was more delayed for tuberculous pneumonia patients than for cavitary tuberculosis patients. The prevalence of underlying comorbidities such cancer, diabetes, alcoholism and long-term steroid use was not different between the two groups. The patients with tuberculous pneumonia were older and they had lower levels of serum albumin and hemoglobin than those with cavitary tuberculosis. The patients with tuberculous pneumonia showed a tendency to have more frequent endobronchial lesion. Tuberculous pneumonia occurred in any lobe, whereas the majority of cavitary tuberculosis patients had upper lung lesion, but the prevalence of lymphadenopathy, pleural effusion and previous tuberculosis scar was not different between the two groups.ConclusionsOlder age, a lower level of serum albumin and hemoglobin and a random distribution of lesion were associated with tuberculosis pneumonia as compared with cavitary tuberculosis. These findings suggest that the pathogenesis of tuberculous pneumonia might be different from that of cavitary tuberculosis.

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Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Investigation of Cavitary Tuberculosis and Tuberculous Pneumonia

Lee

Choe

Kim

2006

Korean J Intern Med

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“…In previous studies, TB in the lower lung fields in adults is a frequent characteristic of tuberculous pneumonia, which is manifested as homogeneous segmental or lobar consolidation on a chest radiograph (10,12). On CT, TB lesions might show necrotic or cavitary consolidation, bronchial or bronchiolar lesions including branching opacities, and mass (1,13). These findings could be helpful for differential diagnosis of TB from bacterial pneumonia.…”

Section: Discussionmentioning

confidence: 90%

Apical versus basal involvement of pulmonary tuberculosis: comparison of CT findings

Yoon

Lee²,

Im³

et al. 2012

Diagn Interv Radiol

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T uberculosis (TB) is a common infection worldwide and remains an important cause of morbidity and mortality, particularly in developing countries (1). In 2010, 8.8 million people developed overt disease; approximately 1.1 million deaths occurred among human immunodeficiency virus (HIV)-negative people and 0.35 million deaths occurred among HIV-positive people (2).Several host factors may contribute to radiologic manifestations of pulmonary TB, including prior exposure to TB, age, and underlying immune status (3). Radiologic manifestation of pulmonary TB has been divided into primary and postprimary TB, each with a characteristic radiologic pattern. Primary TB occurs most commonly in children without prior exposure to TB and without acquired specific immunity. Primary TB commonly presents as hilar or mediastinal lymphadenopathy, airspace consolidation, or pleural effusion. Postprimary TB is considered to be a reactivation of a previous TB lesion. Radiographically, postprimary TB usually presents as focal or patchy heterogeneous consolidation involving the apical and posterior segments of the upper lobes and less frequently in the superior segments of the lower lobes. On computed tomography (CT) scans, the most common findings of postprimary TB are centrilobular small nodules, branching linear and nodular opacities (tree-in-bud sign), patchy or lobular areas of consolidation, and cavitation (1, 3-6).Isolated involvement of basal segments of the lower lobes in pulmonary TB cases is unusual, and often causes great confusion in the diagnosis of pulmonary TB (3, 7). Because early diagnosis of pulmonary TB plays an important role in the treatment of TB, proper understanding of atypical radiologic manifestation is critical (8, 9).To the best of our knowledge, the CT findings of pulmonary TB involving basal segments have not been widely investigated. The present study compared clinical features and CT findings of pulmonary TB in basal segments and apical or apicoposterior segments, and assessed the frequent radiologic findings of TB in basal segments. Materials and methods PatientsApproval of the hospital ethics committee was obtained for this study. We retrospectively reviewed chest CT scans of 986 consecutive adults who were diagnosed with active pulmonary TB at our institution, an 814-bed urban community-based university teaching hospital, from March 2005 to February 2011. Patients were included in the study if they had a positive culture or staining for Mycobacterium tuberculosis from a sputum specimen, bronchial washing, or lung biopsy. Disease confined to the basal segments of the lower lobes, segments 7, 8, 9, and 10 of the right lower lobe and segments 7+8, 9, and 10 of the left lower lobe, was found in 21 patients. We excluded pulmonary TB cases involving CHEST IMAGING ORIGI NAL ARTICLE CT findings in apical versus basal involvement of pulmonary tuberculosisJi Young Yoon, In Jae Lee, Hyoung June Im, Kwanseop Lee, Yul Lee, Sang Hoon Bae PURPOSE We aimed to compare clinical features and computed tomography (CT) n...

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