Chest Radiography Interpretation: Pulmonary TB ppt

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
Primary Tuberculosis: Pleura
Primary Tuberculosis: Pleura
Primary Tuberculosis: Pleura
• Effusions common in adults
• Less common in children
• May be only finding in primary
disease
• Effusions common in adults
• Less common in children
• May be only finding in primary
disease
1
1
°
°
TB: Pleural Effusion
TB: Pleural Effusion
Post-primary Tuberculosis
Lung Parenchyma
Post
Post
-
-
primary Tuberculosis
primary Tuberculosis
Lung Parenchyma
Lung Parenchyma
• Distribution

 apical/posterior segments of upper lobes
 superior segments of lower lobes
 right side more common
 isolated anterior segment involvement is
unusual (think M. avium complex)
• Distribution


apical/posterior segments of upper lobes
apical/posterior segments of upper lobes


superior segments of lower lobes
superior segments of lower lobes


right side more common
right side more common


isolated anterior segment involvement is
isolated anterior segment involvement is
unusual (think
unusual (think
M.
M.
avium
avium
complex)
complex)

Post
Post
-
-
primary TB
primary TB
• Patterns of disease
 air space consolidation
 cavitation, cavitary nodule
 endobronchial spread
 miliary
 bronchostenosis
 tuberculoma
• Patterns of disease


air space consolidation
air space consolidation


cavitation
cavitation
,
,
cavitary
cavitary
nodule
nodule



endobronchial
endobronchial
spread
spread


miliary
miliary


bronchostenosis
bronchostenosis


tuberculoma
tuberculoma
Post-primary Tuberculosis
Lung Parenchyma
Post
Post
-
-
primary Tuberculosis
primary Tuberculosis
Lung Parenchyma
Lung Parenchyma
Post
Post
-
-

primary
primary
TB: Consolidation
TB: Consolidation
Post
Post
–
–
1
1
°
°
TB: RX
TB: RX
Post
Post
-
-
primary
primary
TB:
TB:
Cavitation
Cavitation
Post
Post
-
-
primary TB:
primary TB:

Cavitary
Cavitary
Nodule
Nodule
Post
Post
–
–
1
1
°
°
TB: R
TB: R
X
X
Post 1
Post 1
°
°
TB:
TB:
Endobronchial
Endobronchial
Spread of
Spread of
Infection
Infection
Post
Post

-
-
primary TB:
primary TB:
Miliary
Miliary
Post
Post
-
-
primary TB:
primary TB:
Bronchostenosis
Bronchostenosis
Post
Post
-
-
primary TB:
primary TB:
Bronchostenosis
Bronchostenosis
Post
Post
-
-
primary TB:
primary TB:
Tuberculoma
Tuberculoma