Nodular reverse halo sign in active pulmonary tuberculosis: A rare CT feature?

Martini, Katharina; Loubet, Antoine; Bankier, Alexander A.; Bouam, Samir; Morand, Pauline; Cassagnes, L.; Revel, Marie; Chassagnon, Guillaume

doi:10.1016/j.diii.2020.01.013

Cited by 6 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In approximately 10% of patients, lung involvement of by COVID-19 pneumonia may present as arciform or pseudonodular consolidation suggesting a pattern of organizing pneumonia [20], sometimes with a "reverse halo sign" similar to the one observed in other infectious diseases [21]. Unilateral presentation is possible in about 20-30% of patients, usually at an early stage before bilateralization of the lesions [5,22].…”

Section: Atypical Ct Presentationmentioning

confidence: 97%

Chest CT in COVID-19 pneumonia: A review of current knowledge

Jalaber

Lapotre

Morcet-Delattre

et al. 2020

Diagnostic and Interventional Imaging

105

View full text Add to dashboard Cite

The current COVID-19 pandemic has highlighted the essential role of chest computed tomography (CT) examination in patient triage in the emergency departments, allowing them to be referred to "COVID" or "non-COVID" wards. Initial chest CT examination must be performed without intravenous administration of iodinated contrast material, but contrast material administration is required when pulmonary embolism is suspected, which seems to be frequent in severe forms of the disease. Typical CT features consist of bilateral ground-glass opacities with peripheral, posterior and basal predominance. Lung disease extent on CT correlates with clinical severity. Artificial intelligence could assist radiologists for diagnosis and prognosis evaluation.

show abstract

Section: Atypical Ct Presentationmentioning

confidence: 97%

Chest CT in COVID-19 pneumonia: A review of current knowledge

Jalaber

Lapotre

Morcet-Delattre

et al. 2020

Diagnostic and Interventional Imaging

105

View full text Add to dashboard Cite

show abstract

“…Some material is coughed out to form cavities. That which is not coughed out is retained to become the focus of post primary granulomas that produce the nodular reverse halo sign on CT [ 119 ]. These lesions are not round, but follow the branching cylindrical shape of the bronchogenic caseous pneumonia that they surround.…”

Section: Later Lesions Of Pptbmentioning

confidence: 99%

“…Post-primary granulomas begin by surrounding existing foci of caseous pneumonia and then shrink slightly as the caseation ages. This process produces the reverse halo sign on X-ray [ 119 , 146 ].…”

Section: Immunity To Primary and Post-primary Tbmentioning

confidence: 99%

The Pathogenesis of Tuberculosis–The Koch Phenomenon Reinstated

Hunter

2020

Pathogens

View full text Add to dashboard Cite

Research on the pathogenesis of tuberculosis (TB) has been hamstrung for half a century by the paradigm that granulomas are the hallmark of active disease. Human TB, in fact, produces two types of granulomas, neither of which is involved in the development of adult type or post-primary TB. This disease begins as the early lesion; a prolonged subclinical stockpiling of secreted mycobacterial antigens in foamy alveolar macrophages and nearby highly sensitized T cells in preparation for a massive necrotizing hypersensitivity reaction, the Koch Phenomenon, that produces caseous pneumonia that is either coughed out to form cavities or retained to become the focus of post-primary granulomas and fibrocaseous disease. Post-primary TB progresses if the antigens are continuously released and regresses when they are depleted. This revised paradigm is supported by nearly 200 years of research and suggests new approaches and animal models to investigate long standing mysteries of human TB and vaccines that inhibit the early lesion to finally end its transmission.

show abstract

“…11 ). A recent study revealed an incidence of nodular RHS of 17% in a cohort of patient with active PTB [ 34 ]. The RHS in TB was described mainly in the right upper lobe with one or two such lesions being identified in most of the cases [ 9 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

“…A recent study revealed an incidence of nodular RHS of 17% in a cohort of patient with active PTB [ 34 ]. The RHS in TB was described mainly in the right upper lobe with one or two such lesions being identified in most of the cases [ 9 , 34 ]. Furthermore, RHS was associated with perilymphatic-predominant nodularity but not centrilobular-predominant nodularity in another recent study [ 13 ] (Fig.…”

Section: Introductionmentioning

confidence: 99%

Active pulmonary tuberculosis: something old, something new, something borrowed, something blue

et al. 2022

View full text Add to dashboard Cite

Tuberculosis remains a major global health issue affecting all countries and age groups. Radiology plays a crucial role in the diagnosis and management of pulmonary tuberculosis (PTB). This review aims to improve understanding and diagnostic value of imaging in PTB. We present the old, well-established findings ranging from primary TB to the common appearances of post-primary TB, including dissemination with tree-in-bud nodularity, haematogenous dissemination with miliary nodules and lymphatic dissemination. We discuss new concepts in active PTB with special focus on imaging findings in immunocompromised individuals. We illustrate PTB appearances borrowed from other diseases in which the signs were initially described: the reversed halo sign, the galaxy sign and the cluster sign. There are several radiological signs that have been shown to correlate with positive or negative sputum smears, and radiologists should be aware of these signs as they play an important role in guiding the need for isolation and empirical anti-tuberculous therapy.

show abstract

Nodular reverse halo sign in active pulmonary tuberculosis: A rare CT feature?

Cited by 6 publications

References 14 publications

Chest CT in COVID-19 pneumonia: A review of current knowledge

Chest CT in COVID-19 pneumonia: A review of current knowledge

The Pathogenesis of Tuberculosis–The Koch Phenomenon Reinstated

Active pulmonary tuberculosis: something old, something new, something borrowed, something blue

Contact Info

Product

Resources

About