-
Buzz
- Like sarcoid
- lymphatics and lymph nodes
- primary and secondary behave same way
- different
- age
- location
- Like sarcoid
TB of the lung is an infection caused by mycobacterium TB with two phases – an activation phase and a reactivation phase adenopathy a
Inhaled droplets of Mycobacterium
- Immediate clearance of the organism
- Primary disease: immediate onset of active disease
- Latent infection
- Reactivation disease: onset of active disease many years following a period of latent infection
- Consolidation
- Cavitation
- Miliary
key Dx feature upper or Rt middle lobe involvement initial exudative phase, vol loss instead of exp hypersensitivity rxn causes chronic inflam phase caseation necrosis after 6 wks
Radiology
Primary tuberculosis demonstrates
lymphadenopathy,
consolidation, (CAVITATION UNCOMMON)
pleural effusion, and
miliary nodules
middle lobes
upper portion of lower lobes or lower portion of upper lobes
Ghon lesion, sometimes called Ghon focus,
initial tuberculous granuloma formed during primary infection and is not radiologically visible unless it calcifies – this occurs
represents a tuberculous caseating granuloma (tuberculoma) and represents the sequelae of primary pulmonary tuberculosis infection.
Ghon complex.
is a Ghon focus alongside ipsilateral mediastinal lymphadenopathy
Ranke complex
is calcified Ghon complex (Ghon lesion and ipsilateral lymph node) representing a progression of the Ghon complex
radiologically detectable
- 30 year old Female with Positive Sputum
- multiple tree-in-bud opacities and nodules
- measuring up to 8 mm in
- peribronchial vascular distribution in the
- left upper lobe the,
- lingula,
- left lower lobe,
- withslight surrounding groundglass.
- several bilateral calcified granulomas.
- CXR showed
-
3 Months Later on Treatment
-
- multiple tree-in-bud opacities and nodules
CT showed
Postprimary tuberculosis
(aka – reactivation TB and secondary TB)
consolidations that are predominant in the apical and upper lung zones,
nodules, and
cavitation
-
Active TB
-
- as primary tuberculosis, developing shortly after infection,
- or postprimary tuberculosis
- Stability of radiographic findings for 6 months distinguishes inactive from active disease
- Primary Active
-
-
- lymphadenopathy,
- consolidation,
- pleural effusion, and
- miliary nodules
-
-
- Reactivation
- consolidations that are predominant in the apical and upper lung zones,
- nodules
- tree in bud
- cavitation
-
Primary Active and Reactivation
miliary tuberculosis is evenly distributed throughout both lungs
References and Links
- Radiographics
- Nachiappan, A.C et al Pulmonary Tuberculosis: Role of Radiology in Diagnosis and Management RadioGraphicsVol. 37, No. 1 2017
- Rossi, SE et al Tree-in-Bud Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview RadioGraphicsVol. 25, No. 3 2005
-
Bhalla, A S et al Chest tuberculosis: Radiological review and imaging recommendation Indian J Radiol Imaging. 2015 Jul-Sep; 25(3): 213–225.
- Radiopaedia
-
TCV