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Jung MK, Lee SY, Ko JM, Im SA. The Effect of Diabetes Control Status on CT Findings in Pulmonary Tuberculosis: Emphasis on Bronchial Erosive Changes. J Clin Med 2023; 12:4725. [PMID: 37510840 PMCID: PMC10380713 DOI: 10.3390/jcm12144725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
PURPOSE Studies on the effect of diabetes mellitus (DM) on the radiologic findings of pulmonary tuberculosis (PTB) have reported inconsistent results. These findings may have been influenced by the glycemic control status of the patients studied. To our knowledge, no recent data have described the effect of the DM control status on CT findings in PTB in terms of medium-sized airway involvement that is visualized as bronchial erosion on CT. The aim of this present study was to determine whether the DM control status influenced radiological manifestations in patients with PTB, with an emphasis on bronchial erosive changes. METHODS We conducted a retrospective single-center study on patients who were newly diagnosed with PTB. A total of 426 consecutive patients with PTB who underwent CT scans at the time of diagnosis from 1 January 2017 to 31 March 2020 were included in this study. The included patients were categorized as having no DM (non-DM), controlled DM, or uncontrolled DM. The patient medical charts, microbiology study results, and pulmonary changes on the CT scans were analyzed. RESULTS Among 426 patients with PTB who underwent CT scans at the time of diagnosis, 91 were excluded either due to undetermined hemoglobin A1C (HbA1C) levels (n = 25) or concomitant pulmonary diseases (n = 66) that would make the analysis of the pulmonary changes on CT scans difficult. Finally, 335 patients were included in this study (224 men and 111 women; mean age, 59 years; range, 16-95 years). Among the 335 patients, 82 (24.5%) had DM and 52 of those (63.4%) had an uncontrolled status. The frequency of cavitation (43% vs. 23% vs. 79%, p < 0.001) and bronchial erosion (44% vs. 30% vs. 73%, p < 0.001) was significantly different between the three groups. The uncontrolled DM group showed a high frequency of cavitation and bronchial erosion compared to the non-DM (cavitation, p < 0.001 and bronchial erosion, p < 0.001) and controlled DM groups (p < 0.001 and p < 0.001). However, the frequency of cavitation and bronchial erosion in the controlled DM group was not different compared to the non-DM group. CONCLUSION The glycemic status (HbA1C ≥ 7.0), not the presence of DM, influenced the radiologic manifestations of PTB, especially in terms of medium-sized bronchial involvement, appearing as bronchial erosive changes and the feeding bronchus sign on chest CT scans. This difference in the uncontrolled DM group was likely to contribute to the higher frequency of cavitation.
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Affiliation(s)
- Min Kyung Jung
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sang Young Lee
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jeong Min Ko
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Soo-Ah Im
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Aurangabadkar GM, Choudhary SS, Khan SM, Jadhav US, Wagh PB, Ali SN. Post-tubercular Unilateral Lung Destruction: A Complicated Case. Cureus 2023; 15:e40035. [PMID: 37425496 PMCID: PMC10325140 DOI: 10.7759/cureus.40035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Pulmonary tuberculosis is associated with long-term complications that affect both the respiratory and cardiovascular systems. We present the case of a 65-year-old male patient who presented with chief complaints of productive cough and breathlessness for the last four years. Further radiological investigations revealed a left-sided destroyed lung with left lung collapse and deviation of the mediastinum towards the left side. The patient responded well to treatment with broad-spectrum antimicrobial drugs and mucolytics.
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Affiliation(s)
- Gaurang M Aurangabadkar
- Respiratory Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed University), Nagpur, IND
| | - Sumer S Choudhary
- Respiratory Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed University), Nagpur, IND
| | - Shafee M Khan
- Respiratory Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed University), Nagpur, IND
| | - Ulhas S Jadhav
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed University), Wardha, IND
| | - Pankaj B Wagh
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed University), Wardha, IND
| | - Saood N Ali
- Respiratory Medicine, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, IND
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3
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Rana A, Krishnan V, Aggarwal A. Unusual patterns of tuberculosis on cross-sectional imaging: a pictorial review. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00875-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Tuberculosis is routinely encountered on imaging throughout the world. Radiologists are usually familiar with the common patterns of tuberculosis on cross-sectional imaging. However, tuberculosis frequently presents with unfamiliar imaging patterns and/or uncommon anatomic sites which still pose a diagnostic challenge.
Discussion
Rapid improvements in the management of acquired immunodeficiency syndrome patients leading to increased survival as well as advances in chemotherapy and immunosuppressive medication have complicated the presentation of tuberculosis by increasing the probability of unconventional sites and patterns of involvement in tuberculosis leading to unfamiliar imaging appearances. In this review, we describe these unfamiliar imaging patterns of tuberculosis and provide a diagnostic protocol for arriving at the right diagnosis and differentiating these from other pathologies with similar imaging appearances. These are described through case-based illustrations of unusual patterns and anatomic locations of tuberculosis.
Conclusions
It is important for radiologists to be aware of such unusual imaging patterns of tuberculosis in order to facilitate early and accurate diagnosis for appropriate patient management in the face of changing patient demographics and pathological profile of tuberculosis in the current era of scientific advancements.
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Tang F, Lin LJ, Guo SL, Ye W, Zha XK, Cheng Y, Wu YF, Wang YM, Lyu XM, Fan XY, Lyu LP. Key determinants of misdiagnosis of tracheobronchial tuberculosis among senile patients in contemporary clinical practice: A retrospective analysis. World J Clin Cases 2021; 9:7330-7339. [PMID: 34616799 PMCID: PMC8464447 DOI: 10.12998/wjcc.v9.i25.7330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/11/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Tracheobronchial tuberculosis (TBTB) is a common subtype of pulmonary tuberculosis. Concomitant diseases often obscure the diagnosis of senile TBTB.
AIM To characterize senile patients with TBTB and to identify the potential causes of misdiagnosis.
METHODS One hundred twenty patients with senile TBTB who were admitted to the Anhui Chest hospital between May 2017 and May 2019 were retrospectively analyzed. Patients were classified as diagnosed group (n = 58) and misdiagnosed group (n = 62). Clinical manifestations, laboratory results, radiographic data, and endoscopic findings were compared between the two groups.
RESULTS Patients in the misdiagnosed group were most commonly diagnosed as pulmonary tuberculosis (non-TBTB, 29/62, 46.8%), general pneumonia (9/62, 14.5%), chronic obstructive pulmonary disease (8/62, 12.9%), and tracheobronchial carcinoma (7/62, 11.3%). The time elapsed between disease onset and confirmation of diagnosis was significantly longer in the misdiagnosed group [median (first quartile, third quartile): 6.32 (4.94, 16.02) mo vs 3.73 (2.37, 8.52) mo]. The misdiagnosed group had lower proportion of patients who underwent bronchoscopy [33.87% (21/62) vs 87.93% (51/58)], chest computed tomography (CT) scan [69.35% (43/62) vs 98.28% (57/58)], and those who showed CT signs of tuberculosis [27.91% (12/62) vs 50% (29/58)] as compared to that in the diagnosed group (P < 0.05). There were no significant between-group differences with respect to age, gender, occupation, clinical manifestations, or prevalence of comorbid chronic diseases (P > 0.05).
CONCLUSION Insufficient or inaccurate radiographic or bronchoscopic assessment was the predominant cause of delayed diagnosis of TBTB. Increased implementation and better interpretation of CT scan and early implementation of bronchoscopy can help reduce misdiagnosis of senile TBTB.
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Affiliation(s)
- Fei Tang
- Department of Geriatric Respiratory and Critical Care, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
| | - Lian-Jun Lin
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China
| | - Shu-Liang Guo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Wei Ye
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
| | - Xian-Kui Zha
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
| | - Yu Cheng
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
| | - Ying-Feng Wu
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
| | - Yue-Ming Wang
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
| | - Xiao-Mei Lyu
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
| | - Xiao-Yun Fan
- Department of Geriatric Respiratory and Critical Care, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Li-Ping Lyu
- Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
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Chatterjee A, Sen Dutt T, Ghosh P, Mukhopadhyay S, Chandra A, Sen S. Inflammatory Lesions Mimicking Chest Malignancy: CT, Bronchoscopy, EBUS, and PET Evaluation From an Oncology Referral Center. Curr Probl Diagn Radiol 2021; 51:235-249. [PMID: 33483189 DOI: 10.1067/j.cpradiol.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022]
Abstract
Infective and inflammatory diseases can mimic malignancy of the lung. Granulomatous inflammations are common causes of pulmonary nodule, mass, or nodal disease. Systemic infection or inflammation also commonly involves the lung that may raise suspicion of a malignant process. Even in patients with a known malignancy, inflammatory diseases can simulate new metastasis or disease progression. Knowledge of the imaging features of these diseases is essential to prevent missed or overdiagnosis of malignancy. Radiologists also need to be familiar with the scope and limitations of bronchoscopy, endobronchial ultrasound, PET-CT, and biopsy to guide clinical management. In this review, we discuss the imaging features and diagnostic approach of common mimickers of chest malignancy that involve the chest wall, pleura, lung parenchyma, and mediastinal nodes.
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Affiliation(s)
- Argha Chatterjee
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India.
| | - Tiyas Sen Dutt
- Department of Pulmonology, Tata Medical Center, Kolkata, West Bengal, India
| | - Priya Ghosh
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Sumit Mukhopadhyay
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Aditi Chandra
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Saugata Sen
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
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6
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Singh H, Sood R, Chaira T, Khanna A, Upadhaya DJ, Bambal R, Bhatnagar PK, Singh M, Kaur IP. Encapsulating Rifampicin into SLNs: A Viable Option for Managing its Bioavailability Issues Upon Co-Delivery with Isoniazid. Curr Drug Deliv 2020; 17:343-347. [PMID: 32077827 DOI: 10.2174/1567201817666200220121306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/24/2019] [Accepted: 01/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Rifampicin is known to degrade at the acidic pH of the stomach, especially in the presence of isoniazid. Although isoniazid also degrades partially, its degradation is reversible. OBJECTIVE Presently, we provide a proof of the fact that the simultaneous oral administration of rifampicin (RIF), upon incorporation into solid lipid nanoparticles (RIF-SLNs), with isoniazid (INH) overcomes its INH-induced degradation and improves its oral bioavailability in rats. METHODS Solid lipid nanoparticles of RIF (RIF-SLNs) were prepared using a novel and patented method. The effect of INH was investigated on in vivo bioavailability of RIF both in its free and encapsulated (RIF-SLNs) form, after oral administration to rats. RESULTS Cmax and AUC0-∞ of RIF increased 158 % and 125 %, respectively, upon incorporation into SLNs versus free RIF when combined with INH. The Tmax decreased from 5.67 h to 3.3 h, and the plasma concentration of RIF remained above its MIC (8 μg/ml) at all the tested time points starting with 15 min, when administered as RIF-SLNs in combination with INH. CONCLUSION The results confirm the scope of combining RIF-SLNs with INH to overcome the bioavailability of free RIF when combined with INH, especially in fixed dose combinations.
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Affiliation(s)
- Harinder Singh
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh-160014, India
| | - Ruchi Sood
- Daiichi Sankyo Life Science Research Centre in India, A unit of Daiichi Sankyo India Pharma Pvt Limited, Village Sarhaul, Sector-18, UdyogVihar Industrial Area, Gurgaon-122015, Haryana, India
| | - Tridib Chaira
- Daiichi Sankyo Life Science Research Centre in India, A unit of Daiichi Sankyo India Pharma Pvt Limited, Village Sarhaul, Sector-18, UdyogVihar Industrial Area, Gurgaon-122015, Haryana, India
| | - Alka Khanna
- Daiichi Sankyo Life Science Research Centre in India, A unit of Daiichi Sankyo India Pharma Pvt Limited, Village Sarhaul, Sector-18, UdyogVihar Industrial Area, Gurgaon-122015, Haryana, India
| | - Dilip J Upadhaya
- Daiichi Sankyo Life Science Research Centre in India, A unit of Daiichi Sankyo India Pharma Pvt Limited, Village Sarhaul, Sector-18, UdyogVihar Industrial Area, Gurgaon-122015, Haryana, India
| | - Ramesh Bambal
- Daiichi Sankyo Life Science Research Centre in India, A unit of Daiichi Sankyo India Pharma Pvt Limited, Village Sarhaul, Sector-18, UdyogVihar Industrial Area, Gurgaon-122015, Haryana, India
| | - Pradip K Bhatnagar
- Daiichi Sankyo Life Science Research Centre in India, A unit of Daiichi Sankyo India Pharma Pvt Limited, Village Sarhaul, Sector-18, UdyogVihar Industrial Area, Gurgaon-122015, Haryana, India
| | - Mandeep Singh
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh-160014, India
| | - Indu Pal Kaur
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh-160014, India
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7
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Advanced Technologies for Imaging and Visualization of the Tracheobronchial Tree. Thorac Surg Clin 2018; 28:127-137. [DOI: 10.1016/j.thorsurg.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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8
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Update on childhood and adult infectious tracheitis. Med Mal Infect 2017; 47:443-452. [PMID: 28757125 PMCID: PMC7125831 DOI: 10.1016/j.medmal.2017.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 07/24/2016] [Accepted: 06/19/2017] [Indexed: 12/11/2022]
Abstract
The trachea is a pivotal organ of the respiratory tract. Rather than a genuine anatomic border, it acts as a crossroad in all respiratory infectious processes. Even though not strictly limited to the trachea, infections such as laryngotracheitis and tracheobronchitis are frequently diagnosed in children, in particular during the winter season. Infectious tracheitis etiologies are diverse and the distinction between viral and bacterial origins, albeit difficult, remains relevant considering the substantial differences in terms of gravity and therapeutic management. This literature review summarizes the microbiological and clinical aspects of community-acquired and nosocomial tracheitis in adults and children, as well as the adequate diagnostic and therapeutic approaches. It also highlights the emergence of fungal tracheitis in immunocompromised patients, of ventilator-associated tracheitis in intensive care medicine, and beyond all that the potential short and long-term consequences of tracheitis.
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10
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Endotracheal Tuberculosis in a Patient with Smear-Negative Sputum. Arch Bronconeumol 2017; 53:592-593. [PMID: 28359607 DOI: 10.1016/j.arbres.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 02/14/2017] [Indexed: 11/23/2022]
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11
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Barnes D, Gutiérrez Chacoff J, Benegas M, Perea RJ, de Caralt TM, Ramirez J, Vollmer I, Sanchez M. Central airway pathology: clinic features, CT findings with pathologic and virtual endoscopy correlation. Insights Imaging 2017; 8:255-270. [PMID: 28197883 PMCID: PMC5359148 DOI: 10.1007/s13244-017-0545-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/16/2017] [Accepted: 01/18/2017] [Indexed: 12/15/2022] Open
Abstract
Objectives To describe the imaging features of the central airway pathology, correlating the findings with those in pathology and virtual endoscopy. To propose a schematic and practical approach to reach diagnoses, placing strong emphasis on multidetector computed tomography (MDCT) findings. Methods We reviewed our thoracic pathology database and the central airway pathology-related literature. Best cases were selected to illustrate the main features of each disease. MDCT was performed in all cases. Multiplanar and volume-rendering reconstructions were obtained when necessary. Virtual endoscopy was obtained from the CT with dedicated software. Results Pathological conditions affecting the central airways are a heterogeneous group of diseases. Focal alterations include benign neoplasms, malignant neoplasms, and non-neoplastic conditions. Diffuse abnormalities are divided into those that produce dilation and those that produce stenosis and tracheobronchomalacia. Direct bronchoscopy (DB) visualises the mucosal layer and is an important diagnostic and therapeutic weapon. However, assessing the deep layers or the adjacent tissue is not possible. MDCT and post-processing techniques such as virtual bronchoscopy (VB) provide an excellent evaluation of the airway wall. Conclusion This review presents the complete spectrum of the central airway pathology with its clinical, pathological and radiological features. Teaching points • Dividing diseases into diffuse and focal lesions helps narrow the differential diagnosis. • Focal lesions with nodularity are more likely to correspond to tumours. • Focal lesions with stenosis are more likely to correspond to inflammatory disease. • Posterior wall involvement is the main feature in diffuse lesions with stenosis.
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Affiliation(s)
- Daniel Barnes
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | | | - Mariana Benegas
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Rosario J Perea
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Teresa M de Caralt
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - José Ramirez
- Pathology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Marcelo Sanchez
- Radiology Department, Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
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12
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Varona Porres D, Persiva O, Pallisa E, Andreu J. Radiological findings of unilateral tuberculous lung destruction. Insights Imaging 2017; 8:271-277. [PMID: 28197882 PMCID: PMC5359149 DOI: 10.1007/s13244-017-0547-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/26/2017] [Accepted: 02/01/2017] [Indexed: 01/15/2023] Open
Abstract
Objectives The aim of this report is to identify the radiological findings of unilateral tuberculous lung destruction (UTLD). Materials and methods Thirteen patients with (UTLD) were reviewed from 1999 to 2014. Only patients with radiological evidence of absence of pulmonary parenchyma preserved were included. Clinical and demographic data were obtained and radiological studies (chest radiograph and CT) were retrospectively reviewed. Results The left lung was more commonly involved (85%). The following radiological findings were found in all cases: a decrease in the diameter of the pulmonary vessels of the affected lung, herniation of the contralateral lung and hypertrophy of the ribs and/or thickening of extrapleural fat. Two radiological patterns were identified: UTLD with cystic bronchiectasis (85%) and UTLD without residual cystic bronchiectasis (15%). Forty-six per cent of cases had respiratory infection symptoms with presence of air-fluid levels in the affected lung as the most common finding in these patients. Conclusions Total unilateral post-tuberculous lung destruction is an irreversible complication with the following main radiological features: predominantly left-sided location, decreases in the diameter of the ipsilateral pulmonary vessels, herniation of the contralateral lung and hypertrophy of the ribs and/or thickening of extrapleural fat. Teaching Points • Unilateral tuberculous lung destruction is an irreversible complication of tuberculosis. • Left-side predominance and herniation of the contralateral lung are characteristic. • Decreased diameter of the ipsilateral pulmonary vessels occurred in all patients. • The pattern with residual cystic bronchiectasis is the most frequent. • Superimposed non-tuberculous infections may affect the destroyed lung.
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Affiliation(s)
- Diego Varona Porres
- Hospital Vall d´Hebrón. Radiology department, Passeig Vall d´Hebrón 119, 08035, Barcelona, Spain.
| | - Oscar Persiva
- Hospital Vall d´Hebrón. Radiology department, Passeig Vall d´Hebrón 119, 08035, Barcelona, Spain
| | - Esther Pallisa
- Hospital Vall d´Hebrón. Radiology department, Passeig Vall d´Hebrón 119, 08035, Barcelona, Spain
| | - Jordi Andreu
- Hospital Vall d´Hebrón. Radiology department, Passeig Vall d´Hebrón 119, 08035, Barcelona, Spain
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Abstract
Despite significant improvements in the diagnosis and treatment of tuberculosis achieved during the last 3 decades, tuberculosis still remains one of the deadliest communicable diseases worldwide. Tuberculosis is still present in all regions of the world, with a more significant impact in developing countries. This article reviews the most common imaging manifestations of primary and postprimary tuberculosis, their complications, and the critical role of imaging in the diagnosis and follow-up of affected patients.
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Affiliation(s)
- Carlos Santiago Restrepo
- Department of Radiology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7800, San Antonio, TX 78229-3900, USA.
| | - Rashmi Katre
- Department of Radiology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7800, San Antonio, TX 78229-3900, USA
| | - Amy Mumbower
- Department of Radiology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7800, San Antonio, TX 78229-3900, USA
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Scaglione M, Linsenmaier U, Schueller G, Berger F, Wirth S. Infection. EMERGENCY RADIOLOGY OF THE CHEST AND CARDIOVASCULAR SYSTEM 2016. [PMCID: PMC7120007 DOI: 10.1007/174_2016_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Community-Acquired Pneumonia (CAP) is the first leading cause of death due to infection worldwide.Many gram-positive, gram-negative bacteria, funguses and viruses can cause the infectious pulmonary disease, and the severity of pneumonia depends on the balance between the microorganism charge, the body immunity defenses and the quality of the underlying pulmonary tissue. The microorganisms may reach the lower respiratory tract from inhaled air or from infected oropharyngeal secretions. The same organism may produce several different patterns that depend on the balance between the microorganism charge and the body immunity defenses.CAP is classified into three main groups: lobar pneumonia, bronchopneumonia and interstitial pneumonia.Lobar pneumonia is characterized by the filling of alveolar spaces by edema full of white and inflammatory cells. Necrotizing pneumonia consists of a fulminant process associated with focal areas of necrosis that results in abscesses. Bronchopneumonia or lobular pneumonia, is characterized by a peribronchiolar inflammation with thickening of peripheral bronchial wall, the diffusion of inflammation to the centrilobular alveolar spaces and development of nodules.The interstitial pneumonia represents with the destruction and esfoliation of the respiratory ciliated and mucous cells. The interstitial septa, the bronchial and bronchiolar walls become thickened for the inflammation process and lymphocytes interstitial infiltrates.Chest radiography represents an important initial examination in all patients suspected of having pulmonary infection and for monitoring response to therapy.Its role is to identify the pulmonary opacities, their internal characteristics and distribution, pleural effusion and presence of other complications as abscesses and pneumothorax.High spatial CT resolution allows accurate assessment of air space inflammation.The CT findings include nodules, interlobular septal thickening, intralobular reticular opacities, ground-glass opacities, tree-in-bud pattern, lobar-segmental consolidation, lobular consolidation, abscesses, pneumatocele, pleural effusion, pericardial effusion, mediastinal and hilar lymphoadenopaties, airway dilatation and emphysema.
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Affiliation(s)
- Mariano Scaglione
- Dept of Radiology, Pineta Grande Medical Center, Castel Volturno, Caserta, Italy
| | | | | | - Ferco Berger
- VU University Medical Center, Amsterdam, The Netherlands
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Abstract
BACKGROUND Bronchiectasis in tuberculosis (TB) is usually considered chronic traction bronchiectasis associated with healed scars. However, bronchiectasis can occasionally be seen in active TB. PURPOSE To evaluate prevalence, appearance, and changes of bronchiectasis associated with active TB on computed tomography (CT). MATERIAL AND METHODS A total of 391 patients with active TB who had undergone CT scans at the time of diagnosis were included in the study. Active TB was diagnosed when the sputum or the sample obtained by bronchoalveolar lavage tested positive using an acid-fast bacillus (AFB) smear test, polymerase chain reaction (PCR) test, or an AFB culture. The CT scans were reviewed focusing on bronchiectasis within consolidations or nodules. Cases with bronchiectasis beyond the consolidation or nodules were excluded from the study to exclude pre-existing traction bronchiectasis. The prevalence and appearance (cylindrical, varicose, cystic, and presence of focal erosion) of bronchiectasis and its time-dependent changes were analyzed. In addition, the presence of the feeding bronchus sign was checked. Here, the feeding bronchus sign was defined as a CT finding where the cavity communicates with the dilated airway. RESULTS In 100 (25%) of the 391 patients, bronchiectasis was present within consolidations or nodules on CT. The shape of the bronchiectasis was cylindrical in all patients and focal erosions were revealed in 75 patients (75%). Nine patients had both cylindrical and varicose forms of the bronchiectasis. The feeding bronchus sign was observed in 42 patients (42%). Follow-up CT was performed on 19 of 100 patients. The bronchiectasis had progressed in 11 patients (58%), improved in four patients (21%), remained unchanged in one patient (5%), and could not be determined in the remaining three patients (16%). In nine patients, CT images prior to diagnosis were available, and in all these cases, bronchiectasis was newly developed. CONCLUSION Bronchiectasis can be seen within active inflammation in one-fourth of active TB on CT. In association with active inflammation, bronchiectasis is mostly cylindrical with focal erosions, occasionally accompanied by the feeding bronchus sign.
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Affiliation(s)
- Jeong Min Ko
- Department of Radiology, St Vincent's Hospital, The Catholic University of Korea
| | - Ki Jun Kim
- Department of Radiology, Incheon St Mary's Hospital, The Catholic University of Korea
| | - Seog Hee Park
- Department of Radiology, Seoul St Mary's Hospital, The Catholic University of Korea, Kyeonggi-do, South Korea
| | - Hyun Jin Park
- Department of Radiology, St Vincent's Hospital, The Catholic University of Korea
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Arora A, Bhalla AS, Jana M, Sharma R. Overview of airway involvement in tuberculosis. J Med Imaging Radiat Oncol 2013; 57:576-81. [DOI: 10.1111/1754-9485.12017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/14/2012] [Indexed: 12/19/2022]
Affiliation(s)
- Arundeep Arora
- Department of Radiodiagnosis; All India Institute of Medical Sciences; New Delhi; India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis; All India Institute of Medical Sciences; New Delhi; India
| | - Manisha Jana
- Department of Radiodiagnosis; All India Institute of Medical Sciences; New Delhi; India
| | - Raju Sharma
- Department of Radiodiagnosis; All India Institute of Medical Sciences; New Delhi; India
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PATHOLOGIE INFECTIEUSE. IMAGERIE THORACIQUE 2013. [PMCID: PMC7156015 DOI: 10.1016/b978-2-294-71321-7.50016-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ganesh SK, Roopleen, Biswas J, Veena N. Role of high-resolution computerized tomography (HRCT) of the chest in granulomatous uveitis: a tertiary uveitis clinic experience from India. Ocul Immunol Inflamm 2011; 19:51-7. [PMID: 21250925 DOI: 10.3109/09273948.2010.525680] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the role of high-resolution computerized tomography (HRCT) of the chest as a diagnostic tool in granulomatous uveitis. DESIGN Observational case series. METHODS Fifty-eight consecutive patients were evaluated with chest HRCT based on clinical diagnosis of granulomatous uveitis, which was further classified using SUN classification as anterior, intermediate, posterior, and panuveitis. Clinical profile, laboratory findings, chest radiographs, and chest HRCT scans were analyzed. RESULTS Of 58 patients, 35 were males and 23 females with mean age of 43.5 years. Forty-seven patients had bilateral and 11 had unilateral involvement. Eighty-one percent of patients referred for chest HRCT demonstrated signs suggestive of tuberculosis, 8.6% patients showed signs suggestive of sarcoidosis, and 10.3% patients showed normal chest HRCT. CONCLUSION Chest HRCT was found to be a useful tool in the diagnosis of granulomatous uveitis, especially tuberculosis associated uveitis, and can aid in therapeutic decisions.
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Affiliation(s)
- Sudha K Ganesh
- Medical Research Foundation, Sankara Nethralaya, Chennai, India.
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Oh JK, Ahn MI, Jung JI, Kim YK, Oh EJ, Park YJ, Han DH. MDCT abnormalities of small- and medium-sized bronchus in active tuberculosis: a new angle on an old disease. Acta Radiol 2011; 52:167-72. [PMID: 21498345 DOI: 10.1258/ar.2010.100202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The incidence and findings of tuberculous invasion of the peripheral bronchus have not been fully investigated with MDCT. Purpose To evaluate the prevalence and findings of MDCT abnormalities of small- and medium-sized bronchus (SMB) in active pulmonary tuberculosis (TB). MATERIAL AND METHODS Using multiplanar reformation, 35 consecutive MDCT scans (follow-up exams available in 14 patients with a mean interval of 8.1 months) were assessed for following abnormalities of SMB: bronchial impaction (BI), wall thickening, dilatation, peribronchial cuff of soft tissue, and bronchocavitary fistula. It was also assessed whether tree-in-buds (TIB) have a tendency to distribute in the territories of diseased SMB, and whether SMB abnormalities are present in patients with relatively mild disease. RESULTS SMB abnormalities were observed in 23 (65.7%) patients with active TB. The most frequent finding was wall thickening (n = 18, 51.4%), followed by BI (n = 13, 37.1%; zigzag-shaped in four), dilatation (n = 11, 31.4%), amputated appearance of air column (n = 11, 31.4%), peribronchial cuff of soft tissue (n = 10, 28.6%), and bronchocavitary fistula (n =8, 22.9%). TIB (n = 29; absent in two patients with SMB) was mainly within (n = 14) or close to (n = 4) the territory of diseased SMB. Follow-up CT frequently showed improvement of wall thickening (11/12) and persistence of bronchial dilatation (11/13). SMB abnormality was present in all of six patients with mild disease. CONCLUSION MDCT shows that tuberculous invasion of the peripheral bronchus may be more frequent than previously thought, of which findings include wall thickening, BI, dilatation, amputated appearance of air column, peribronchial cuff of soft tissue and bronchocavitary fistula.
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Affiliation(s)
- Jin Kyoung Oh
- Department of Radiology, Seoul St Mary’s Hospital, The Catholic University of Korea, Korea
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Cho A, Hur J, Kang WJ, Cho HJ, Lee JH, Yun M, Lee JD. Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction. Eur Radiol 2010; 21:1077-87. [PMID: 21113598 DOI: 10.1007/s00330-010-2006-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 09/17/2010] [Accepted: 10/10/2010] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis. METHODS This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung. RESULTS The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 ± 0.84; malignant SUV 11.8 ± 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%. CONCLUSION Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions.
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Affiliation(s)
- Arthur Cho
- Division of Nuclear Medicine, Department of Radiology, Yonsei University Health System, 134 Shinchon-dong, Seodaemoon-ku, Seoul, South Korea
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Abstract
Tracheobronchial imaging has undergone a major revolution since the advent of MDCT. The improved spatial and temporal resolution not only allows reformatting images that enhance the comprehension of disease before bronchoscopy or surgery, it has introduced newer techniques such as dynamic expiratory imaging to evaluate for tracheomalacia, which can be a subtle, but a confounding entity for patients and clinician alike. Tracheobronchial diseases can be arbitrarily divided into those that cause focal and diffuse narrowing and widening. Such groupings can help develop a practical approach in evaluating diseases of the central airways.
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Affiliation(s)
- Cylen Javidan-Nejad
- Section of Cardiothoracic Imaging, Department of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Box 8131, St. Louis, MO 63110, USA.
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Abstract
Tracheobronchial imaging has undergone a major revolution. The improved spatial and temporal resolution has introduced newer techniques such as dynamic expiratory imaging to evaluate for tracheomalacia. This article describes these techniques.
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Affiliation(s)
- Cylen Javidan-Nejad
- Section of Cardiothoracic Imaging, Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.
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Grenier PA, Beigelman-Aubry C, Brillet PY. Nonneoplastic Tracheal and Bronchial Stenoses. Radiol Clin North Am 2009; 47:243-60. [DOI: 10.1016/j.rcl.2008.11.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kwon YS, Kim H, Kang KW, Koh WJ, Suh GY, Chung MP, Kwon OJ. The Role of Ballooning in Patients with Post-tuberculosis Bronchial Stenosis. Tuberc Respir Dis (Seoul) 2009. [DOI: 10.4046/trd.2009.66.6.431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yong Soo Kwon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Woo Kang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
| | - Won Jung Koh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gee Young Suh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Man Pyo Chung
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - O Jung Kwon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
OBJECTIVE Pulmonary tuberculosis (TB) is a common worldwide infection and a medical and social problem causing high mortality and morbidity, especially in developing countries. The traditional imaging concept of primary and reactivation TB has been recently challenged, and radiologic features depend on the level of host immunity rather than the elapsed time after the infection. We aimed to elaborate the new concept of the diagnosis and treatment of pulmonary TB, to review the characteristic imaging findings of various forms of pulmonary TB, and to assess the role of CT in the diagnosis and management of pulmonary TB. CONCLUSION Fast and more accurate TB testing such as bacterial DNA fingerprinting and whole-blood interferon-gamma assay has been developed. Miliary or disseminated primary pattern or atypical manifestations of pulmonary TB are common in patients with impaired immunity. CT plays an important role in the detection of TB in patients in whom the chest radiograph is normal or inconclusive, in the determination of disease activity, in the detection of complication, and in the management of TB by providing a roadmap for surgical treatment planning. PET scans using 18F-FDG or 11C-choline can sometimes help differentiate tuberculous granuloma from lung malignancy.
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Computed Tomography Findings in Patients With Tracheal Paracoccidioidomycosis. J Comput Assist Tomogr 2008; 32:788-91. [DOI: 10.1097/rct.0b013e3181506752] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE The purpose of this study was to use CT to differentiate anthracofibrosis from endobronchial tuberculosis (TB), both of which are major causes of benign bronchostenosis. MATERIALS AND METHODS We retrospectively reviewed the clinical and CT findings of 49 patients with anthracofibrosis and 35 patients with endobronchial TB diagnosed on the basis of bronchoscopic, microbiologic, and pathologic findings. Forty-five patients with anthracofibrosis and 32 patients with endobronchial TB had bronchostenosis on CT and were enrolled in the analysis. Nine (20%) of 45 patients with anthracofibrosis had coexistent active TB (two, endobronchial TB; six, pulmonary TB; one, TB pleurisy), and 13 (29%) had pulmonary infections other than TB. Two patients with anthracofibrosis and coexistent endobronchial TB were excluded from the analysis. The CT findings were analyzed with emphasis on the pattern, distribution, and location of bronchostenosis and the number of pulmonary lobes involved. RESULTS Anthracofibrosis was more common than endobronchial TB among elderly patients (p < 0.05). Statistically significant findings on CT were the pattern of bronchostenosis, presence of main bronchus involvement, and number of pulmonary lobes involved (p < 0.05). Bronchostenosis with anthracofibrosis usually involves multiple lobar or segmental bronchi. The main bronchus, however, tends to be preserved in anthracofibrosis. Most cases of endobronchial TB involve one lobar bronchus and the ipsilateral main bronchus with contiguity in extent. CONCLUSION Anthracofibrosis can be differentiated from endobronchial TB on CT. Furthermore, CT is helpful in the diagnosis of anthracofibrosis before bronchoscopy is performed.
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Marchiori E, Pozes AS, Souza Junior AS, Escuissato DL, Irion KL, Araujo Neto CD, Barillo JL, Souza CA, Zanetti G. Alterações difusas da traquéia: aspectos na tomografia computadorizada. J Bras Pneumol 2008; 34:47-54. [DOI: 10.1590/s1806-37132008000100009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Accepted: 06/01/2007] [Indexed: 12/22/2022] Open
Abstract
O objetivo deste ensaio pictórico foi apresentar as principais alterações tomográficas observadas em doenças que acometem a traquéia de forma difusa. As doenças estudadas foram amiloidose, traqueobroncopatia osteocondroplástica, traqueobroncomegalia, papilomatose laringo-traqueo-brônquica, linfoma, neurofibromatose, policondrite recidivante, granulomatose de Wegener, tuberculose, paracoccidioidomicose e traqueobroncomalácia. O principal aspecto observado na tomografia computadorizada foi o espessamento das paredes traqueais, com ou sem nodulações, calcificações parietais ou comprometimento da parede posterior. Embora a tomografia computadorizada permita a detecção e a caracterização das doenças das vias aéreas centrais, e a correlação com os dados clínicos reduza as possibilidades diagnósticas, a broncoscopia com biópsia continua sendo o procedimento mais importante no diagnóstico das lesões difusas da traquéia.
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Abstract
BACKGROUND The granulomatous inflammatory response is a manifestation of many lung diseases. OBJECTIVE To evaluate the diagnostic value of epithelioid cell granulomas in bronchoscopic biopsies in daily clinical practice. METHODS The data of 105 patients with epithelioid cell granulomas in biopsy tissue who had undergone the bronchoscopic lung biopsy or bronchial biopsy at the Centre of Pulmonology and Allergology of Vilnius University Hospital Santariski klinikos (Vilnius, Lithuania) were examined. All cases were divided into non-necrotizing epithelioid cell granulomas and epithelioid cell granulomas with necrosis. RESULTS Of all the cases 66% had non-necrotizing epithelioid cell granulomas and 34% had epithelioid cell granulomas with necrosis. Without respect to the presence of necrosis in granulomas, the majority of the patients (79%) had sarcoidosis or tuberculosis; 94% of the patients with sarcoidosis had non-necrotizing epithelioid cell granulomas and the remaining 6% had granulomas with necrosis. The sensitivity of non-necrotizing epithelioid cell granuloma for the diagnosis of sarcoidosis was 94% and specificity 60%. The positive and negative predictive values were 68% and 92%, respectively. Of the patients with tuberculosis 76% had epithelioid cell granulomas with necrosis and 24% had non-necrotizing epithelioid cell granulomas. The sensitivity of epithelioid cell granuloma with necrosis for the diagnosis of tuberculosis was 76% and specificity 85%. The positive and negative predictive values were 69%, and 88%, respectively. CONCLUSION A significant overlap in types of granulomatous inflammation between tuberculosis and sarcoidosis was found. The type of epithelioid cell granuloma alone was not sufficient for the final clinical diagnosis.
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Affiliation(s)
- Edvardas Danila
- Clinic of Chest Diseases, Allergology and Radiology of Vilnius University, Lithuania.
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Mahapatro S, Kane D, Dave S, Khandeparkar J. Post-tuberculous broncho-esophageal fistula. Indian J Thorac Cardiovasc Surg 2007. [DOI: 10.1007/s12055-007-0027-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Beigelman C, Brauner M. [What attitude to adopt before the sequellae of tuberculosis are evident on chest x-ray? Before a chest x-ray image, how do you confirm that a disturbance is a tuberculosis sequellae?]. Rev Mal Respir 2004; 21:S60-4. [PMID: 15344269 DOI: 10.1016/s0761-8425(04)71388-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- C Beigelman
- Service de radiologie, GH Pitié Salpêtrière, Paris, France
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35
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Chung HS. Endobronchial Tuberculosis. Tuberculosis (Edinb) 2004. [DOI: 10.1007/978-3-642-18937-1_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Radiologic manifestations of pulmonary tuberculosis (TB) can vary according to several host factors, including prior exposure to TB, age, and underlying immune status. Although chest radiography is the mainstay in the evaluation of pulmonary TB, CT generally is required to detect fine lesions overlooked on chest radiographs, to define equivocal lesions, or to evaluate complications. High-resolution CT is useful in understanding the pathologic process of the disease and in determining disease activity in selected cases. This article describes the characteristic CT findings of various forms of pulmonary TB and nontuberculous mycobacterial infection according to immune status of the patients, and assesses the role of CT in the diagnosis and management of pulmonary TB.
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Affiliation(s)
- Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, South Korea
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Yilmaz E, Akkoclu A, Sevinc C. CT and MRI appearance of a fistula between the right and left main bronchus caused by tracheobronchial tuberculosis. Br J Radiol 2001; 74:1056-8. [PMID: 11709473 DOI: 10.1259/bjr.74.887.741056] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Tuberculosis of the trachea and main bronchi is a relatively rare disease seen predominantly in elderly patients. We present a case of a fistula between the right and left main bronchus owing to tuberculosis. We describe the CT and MRI appearances.
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Affiliation(s)
- E Yilmaz
- Department of Radiology, Dokuz Eylül University Hospital, Izmir, 35340, Turkey
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Katz DS. Invited Commentary. Radiographics 2001. [DOI: 10.1148/radiographics.21.4.g01jl07859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kim HY, Song KS, Goo JM, Lee JS, Lee KS, Lim TH. Thoracic sequelae and complications of tuberculosis. Radiographics 2001; 21:839-58; discussion 859-60. [PMID: 11452057 DOI: 10.1148/radiographics.21.4.g01jl06839] [Citation(s) in RCA: 166] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pulmonary tuberculosis is caused by Mycobacterium tuberculosis when droplet nuclei laden with bacilli are inhaled. In accordance with the virulence of the organism and the defenses of the host, tuberculosis can occur in the lungs and in extrapulmonary organs. A variety of sequelae and complications can occur in the pulmonary and extrapulmonary portions of the thorax in treated or untreated patients. These can be categorized as follows: (a) parenchymal lesions, which include tuberculoma, thin-walled cavity, cicatrization, end-stage lung destruction, aspergilloma, and bronchogenic carcinoma; (b) airway lesions, which include bronchiectasis, tracheobronchial stenosis, and broncholithiasis; (c) vascular lesions, which include pulmonary or bronchial arteritis and thrombosis, bronchial artery dilatation, and Rasmussen aneurysm; (d) mediastinal lesions, which include lymph node calcification and extranodal extension, esophagomediastinal or esophagobronchial fistula, constrictive pericarditis, and fibrosing mediastinitis; (e) pleural lesions, which include chronic empyema, fibrothorax, bronchopleural fistula, and pneumothorax; and (f) chest wall lesions, which include rib tuberculosis, tuberculous spondylitis, and malignancy associated with chronic empyema. These varieties of radiologic manifestations can mimic other disease entities. Therefore, recognition and understanding of the radiologic manifestations of the thoracic sequelae and complications of tuberculosis are important to facilitate diagnosis.
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Affiliation(s)
- H Y Kim
- Department of Radiology, Ewha Women's University Mokdong Hospital, Seoul, Korea
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Affiliation(s)
- A N Leung
- Department of Radiology, Standard University Medical Center, CA 94305-5105, USA
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