Pulmonology Book


Tuberculosis Related Chest XRay Changes

Aka: Tuberculosis Related Chest XRay Changes, Tuberculosis Chest Imaging Findings, Chest XRay Changes Suggestive of Tb, Ghon Complex
  1. Precautions
    1. Tuberculosis may cause a typical lobar infiltrate
      1. Include Tuberculosis in the differential in higher risk patients
  2. Imaging: Findings in Active Tuberculosis
    1. Cavitary Lung Lesion (higher risk for infectious spread to contagious contacts)
    2. Upper lobe cavitary lesion or infiltrate
      1. Apical and posterior segments often affected
      2. Superior segment of lower lobes may also be affected
    3. Ghon Complex (pathognomonic)
      1. Healed primary peripheral nodular infiltrate
      2. Calcified hilar node
    4. Miliary lesions (disseminated spread throughout lung)
      1. Associated with capillary lesions
      2. Associated with Immunocompromised conditions (e.g. AIDS)
    5. HIV positive Chest XRay correlates with CD4 Count
      1. CD4 Cell Count <200
        1. Mediastinal adenopathy
      2. CD4 Cell Count >200
        1. Upper lobe infiltrates and cavitation
    6. Other non-specific changes
      1. Pleural Effusion
      2. Hilar Adenopathy
    7. Findings not suggestive of prior Tb fibrotic lesion
      1. Isolated Granuloma on Chest XRay

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