Chest Radiography Interpretation: Pulmonary TB Chest Radiography Chest Radiography Interpretation: Interpretation: Pulmonary TB Pulmonary TB Lisa Chen , M.D. Assistant Clinical Professor Pulmonary and Critical Care Division Department of Medicine San Francisco General Hospital Michael Gotway, MD Associate Clinical Professor, Radiology University of California, San Francisco Primary TB: Lung Parenchyma Primary TB: Lung Parenchyma Primary TB: Lung Parenchyma • Distribution: Slight upper lobe predominance but any lobe can be involved • Air-space consolidation • Cavitation is uncommon (<10%) • Miliary pattern • Distribution: Slight upper lobe predominance but any lobe can be involved • Air-space consolidation • Cavitation is uncommon (<10%) • Miliary pattern 1 1 ° ° TB: Lobar Consolidation TB: Lobar Consolidation 1 1 ° ° TB: Lobar Consolidation TB: Lobar Consolidation 1 1 ° ° TB: Lobar Consolidation TB: Lobar Consolidation 1 1 ° ° TB: TB: Miliary Miliary TB TB Primary TB: Hila & Mediastium Primary TB: Primary TB: Hila Hila & & Mediastium Mediastium • Adenopathy is common, particularly in children and HIV infected • Predilection for the right side • Adenopathy is common, particularly in children and HIV infected • Predilection for the right side 1 1 ° ° TB: Adenitis TB: Adenitis 1 1 ° ° TB: Adenitis TB: Adenitis 1 1 ° ° TB: Adenitis TB: Adenitis [...]... Post-primary TB: Consolidation Post – 1° TB: RX Post-primary TB: Cavitation Post-primary TB: Cavitary Nodule Post – 1° TB: RX Post 1° TB: Endobronchial Spread of Infection Post-primary TB: Miliary Post-primary TB: Bronchostenosis Post-primary TB: Bronchostenosis Post-primary TB: Tuberculoma Post-primary TB: Tuberculoma Post-primary TB: Pleura Post-primary TB: Pleura •• Pleural effusions may occur in Pleural... disease •• Air // fluid level is evidence of a Air fluid level is evidence of a bronchopleural fistula bronchopleural fistula Post-primary TB Post-primary TB: Broncho-pleural fistula Chest Radiograph: TB and HIV Chest Radiograph: TB and HIV •• Chest radiograph often shows Chest radiograph often shows primary disease pattern primary disease pattern •• Adenopathy is common and highly Adenopathy is common and... common and highly predictive of tuberculosis predictive of tuberculosis •• Radiograph may be normal in up to Radiograph may be normal in up to 10% of cases 10% of cases HIV & TB: Adenitis HIV & TB: Adenitis The Chest Radiograph: The Chest Radiograph: Healed Tuberculosis Healed Tuberculosis •• Apical pleural thickening Apical pleural thickening •• Calcified granuloma—Ghon lesion Calcified granuloma—Ghon... Post-primary TB Post-primary Tuberculosis Post-primary Tuberculosis Lung Parenchyma Lung Parenchyma •• Patterns of disease Patterns of disease air space consolidation air space consolidation cavitation, cavitary nodule cavitation, cavitary nodule endobronchial spread endobronchial spread miliary miliary bronchostenosis bronchostenosis tuberculoma tuberculoma Post-primary TB: Consolidation Post – 1° TB: RX... granuloma and hilar node Calcified granuloma and hilar node calcification—Ranke complex calcification—Ranke complex •• Fibrosis and volume loss Fibrosis and volume loss Healed TB: Ghon Lesion Healed TB: Ranke Complex Healed TB: Apical Pleural Thickening ... Tuberculosis: Pleura •• Effusions common in adults Effusions common in adults •• Less common in children Less common in children •• May be only finding in primary May be only finding in primary disease disease 1° TB: Pleural Effusion Post-primary Tuberculosis Post-primary Tuberculosis Lung Parenchyma Lung Parenchyma •• Distribution Distribution apical/posterior segments of upper lobes apical/posterior segments . Chest Radiography Interpretation: Pulmonary TB Chest Radiography Chest Radiography Interpretation: Interpretation: Pulmonary TB Pulmonary TB Lisa. Consolidation TB: Lobar Consolidation 1 1 ° ° TB: TB: Miliary Miliary TB TB Primary TB: Hila & Mediastium Primary TB: Primary TB: Hila Hila & & Mediastium Mediastium •