Imaging in extrapulmonary tuberculosis

Gambhir, Sanjay; Ravina, Mudalsha; Rangan, Kasturi; Dixit, Manish; Barai, Sukanta; Bomanji, Jamshed

doi:10.1016/j.ijid.2016.11.003

Cited by 105 publications

(114 citation statements)

References 47 publications

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“…All studies showed significant uptake of FDG or increased SUVmax value in active TB; which resembles with this present study. Hence, 18 F FDG PET-CT imaging may play a potential role in the localization lesions and extension of the EPTB (3,6,7,8).…”

Section: Resultsmentioning

confidence: 99%

“…The test has limitations of being falsely negative in immunocompromised patients, while it gives false-positive results are seen in patients with other types of mycobacteriosis or history of previous vaccinations against TB (3). TB blood tests are also called interferon-gamma release assays or IGRAs that uses a blood sample to find out if someone is infected with TB bacteria, but it cannot differentiate between active and latent TB (5,7).…”

Section: Introductionmentioning

confidence: 99%

“…These two cell types utilize large amount of glucose as the main source of energy for phagocytosis and chemotaxis. Hence, 18 F FDG PET-CT imaging may play a potential role in the localization and extension of the disease (3,6,7,8). It is also reported the efficacy of using FDG PET-CT scan for determining active and latent TB as well as treatment follow up of EPTB (9).…”

Section: Introductionmentioning

confidence: 99%

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18F FDG PET-CT Imaging in the Evaluation of Diagnosed Extra Pulmonary Tuberculosis

Zohra¹,

Begum²,

Akram³

et al. 2019

Bangladesh J. Nuclear Med.

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Objectives: Extra Pulmonary Tuberculosis (EPTB) presents with atypical symptoms and heterogeneous clinical features. Management of EPTB including diagnosis, localization, extension and monitoring treatment response of active disease is quite challenging. Moreover, localization of active disease, differentiation between active and latent disease by conventional methods is troublesome. So this study was done to evaluate the metabolic activity of active disease by 18F Flurodeoxyglucose (FDG) PET-CT in diagnosed cases of EPTB patients. Patients and methods: A total of 17 patients with EPTB were included in this study. FDG PET-CT scan was performed to evaluate the metabolic activity of tubercular lesions before anti-TB treatment. Clinical features, biochemical changes including ESR, WBC count, CRP, MT test and maximum standardized uptake value (SUVmax) of most intense FDG avid lesions and sizes were recorded in 18F FDG PET-CT scan. Results: All 17 patients (09 female, 08 male) had lymph node involvement, two had bone TB and two had abdominal TB. Active TB lesions showed increased FDG uptake in extra-pulmonary tubercular lesions in 16 patients. The mean SUVmax value of the involved lymph nodes were 9.4 ± 6.0 and the mean size (maximum diameter) 19.8 ± 10.4 mm (mean ± SD). One histologically proven EPTB patient had non avid lesions in FDG PET-CT scan. Conclusion: 18F FDG PET-CT scan plays an important role in the localization, extension and differentiation between active and latent TB. In this study, the metabolic activity and size of the involved tubercular lymph nodes were increased in active lesions. Increased FDG uptake in active tubercular lesions may help in treatment monitoring of EPTB. Non avid lesions in EPTB patients revealed suggested latent TB which can change further management plan. Although PET-CT is an expensive technology, application of this sophisticated imaging technique in atypical or doubtful cases of EPTB might modify the treatment plan significantly after proper evaluation of the disease status. , 18F FDG PET-CT scan will be helpful to evaluate the disease status and modification of treatment regime in non-responders cost-effectively. A nationwide large-scale study would be the better way for clinical validation. Bangladesh J. Nuclear Med. 22(1): 9-14, Jan 2019

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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18F FDG PET-CT Imaging in the Evaluation of Diagnosed Extra Pulmonary Tuberculosis

Zohra¹,

Begum²,

Akram³

et al. 2019

Bangladesh J. Nuclear Med.

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“…Imaging techniques such as ultrasound, CT or magnetic resonance imaging of the neck are useful for initial evaluation of lymphadenopathy and can identify the lymph node group most suitable for biopsy, as well as assist in the biopsy [5] . The “gold standard” for diagnosis remains the culture, although it may take up to 3 to 4 weeks to yield results, which represents a major delay in establishing the diagnosis when malignant processes need to be excluded.…”

Section: Discussionmentioning

confidence: 99%

Cervical Lymphadenopathy in a Nonagenarian Woman: What to Think?

Chaves

Nogueira

Rosa

et al. 2019

European Journal of Case Reports in Internal Medicine

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Tuberculosis remains a worldwide public health problem. Cervical tuberculous lymphadenitis (TBL) or scrofula is the most common form of extrapulmonary tuberculosis, affecting the cervical lymph nodes. We report the case of a 93-year-old woman presenting with cervical adenopathies with 3 months duration. Fine needle aspiration (FNA) biopsy yielded a noncaseous granulomatous process, but was negative for Mycobacterium tuberculosis (MT). As the adenopathies had grown, an excisional biopsy was performed. An extensive study of infectious aetiologies was performed, including for MT, with a negative outcome. Owing to the persistence of cervical lymphadenitis with caseous granulomas, a diagnosis of TBL was strongly suspected and presumptive treatment was initiated. Afterwards, diagnostic confirmation was obtained by isolation of MT in the lymph node culture. The patient presented a favourable clinical outcome. This case highlights that a high index of suspicion is essential for the diagnosis of TBL, especially in the elderly, and emphasizes the importance of pursuing diagnostic confirmation, in which FNA and excisional biopsy plays a key role.

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“…In advance disease it may cause obstructive uropathy, bladder defect and loss of kidney function leading to chronic renal failure. Diagnostic imaging may show calcification, distorted ureters with alternate stenosis and dilatation, reduced bladder volume, hydro-nephrosis, chalice distortion, cavities and decreased kidneys size and function in advance disease [8,9].…”

Section: Discussionmentioning

confidence: 99%

Renal Tuberculosis in a 14-Years-Old Boy Presented as Pyrexia of an Unknown Origin (PUO): A First Case Report

Hassan¹

2018

AJP

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Tuberculosis remains an important public health problem, especially in developing countries. Mycobacterium Tuberculosis mainly affects the lungs but extra-pulmonary Tuberculosis is not uncommon. However, renal involvement is very rare particularly in paediatric age group. This article is reporting a case of 14 years old Emirati boy who presented with history of fever, mild cough and night sweats after admission. The patient was treated as a case of fever of unknown origin, most likely secondary to community acquired pneumonia. On further investigations, he was found to have pulmonary tuberculosis with miliary pattern of the both lungs and also renal tuberculosis as the urine culture grew Acid Fast Bacilli (AFB) (Mycobacterium Tuberculosis). The patient responded very well to the Anti-tuberculosis treatment and became symptom free.

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Imaging in extrapulmonary tuberculosis

Cited by 105 publications

References 47 publications

18F FDG PET-CT Imaging in the Evaluation of Diagnosed Extra Pulmonary Tuberculosis

18F FDG PET-CT Imaging in the Evaluation of Diagnosed Extra Pulmonary Tuberculosis

Cervical Lymphadenopathy in a Nonagenarian Woman: What to Think?

Renal Tuberculosis in a 14-Years-Old Boy Presented as Pyrexia of an Unknown Origin (PUO): A First Case Report

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