TB Cavitation 50M with Cavitating Nodule on CXR BAL yielded Mycobacterium Mycobacterium KansasiiAshley Davidoff MDTheCommonVein.net 50M with Cavitating Nodule on CT scan.BAL yielded Mycobacterium KansasiiAshley Davidoff MDTheCommonVein.net Reactivation TBCXR reveals a dense consolidation in the right upper lobe (red arrow) with questionable air-fluid level. No pneumothorax. No pleural effusions. Differential includes right upper lobe pneumonia or tuberculosis. CT is recommended for further evaluation if there is concern for a cavity.Courtesy Joseph Cannella,Dr. Christina LeBedis, MD, MS CTPA reveals a large consolidation in the right upper lobe and superior segment of the right lower lobe spans approximately 8.8 x 5.6 x 9.4 cm and extends to the pleura. There are multiple internal cavitations (red arrows) with air-fluid levels. These large predominately right upper lobe cavitary lesions are consistent with clinical concern for tuberculosis pneumonia, however follow-up with chest CT in 3 months post-treatment is recommended to exclude other less likely causes of cavitary lesions, such as malignancy.Courtesy Joseph Cannella,Dr. Christina LeBedis, MD, MS CT Active TB Cavitation and Ipsilateral Transbronchial Spread with Extensive Tree in Bud Pattern 39-year-old immigrant Vietnamese male presents night sweats fever and coughCXR shows a cavitating lesion in the apex of the right lung (magnified lower image, right) associated with an ipsilateral micronodular pattern (magnified lower image, left)Although the right lung has the appearance of a “miliary” pattern, this term is usually referred to the hematogenous spread of the diseaseAshley Davidoff MD TheCommonvein.net 131708cL CT Active TB Cavitation and Ipsilateral Transbronchial Spread with Extensive Tree in Bud Pattern39-year-old immigrant Vietnamese male presents night sweats, fever, and cough. CT in the coronal plane of the chest shows a large cavitating lesion in the right upper lobe, with innumerable micronodules dominantly in the right midlung field, and to lesser extent in the right upper lung field. Some micronodules are probably present in the left lower lobe as well. Close to the largest subsegmental consolidation there is a bronchus which shows thickening of its wall.Although it has the appearance has a “miliary” pattern, this term is usually referred to the hematogenous spread of the diseaseAshley Davidoff MD TheCommonvein.net 135786c006Lu CT Active TB Cavitation in the Right Upper Lobe39-year-old immigrant Vietnamese male presents night sweats fever and cough. CT in the axial plane of the chest shows a large cavitating lesion in the right upper apex.Ashley Davidoff MD TheCommonvein.net 135787 006Lu 006Lu Postprimary active tuberculosis in a 34-year-old man with weight loss and a chronic cough. (a) High-resolution CT scan of the left lung shows a thick-walled cavity and multiple peripheral small nodules and branching linear structures (arrows). Note the thickening of the bronchial walls (arrowhead). (b) Photomicrograph (original magnification, ×400; hematoxylin-eosin stain) shows impacted caseous material (*) in small peripheral airways (arrow).Rossi, SE et al Tree-in-Bud Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview RadioGraphics Vol. 25, No. 3 2005 TCV Map Introduction TB Cases