Miliary tuberculosis - CT
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There is a large 8 x 4 cm right hilar mass. It is predominantly of soft tissue attenuation, however, there are foci of stippled calcification in a circular pattern within it just lateral to the bronchus intermedius. The mass itself encases the right main stem bronchus as well as right lobar bronchi. There is associated slight narrowing of the encased bronchi.
There is a 1.1 cm enlarged right paratracheal lymph node and a calcified node. Significant subcarinal adenopathy is also noted and has displaced the esophagus to the left. An associated large right pleural efffusion is present.
There are innumerable 1-2mm pulmonary nodules distributed in a random pattern. Several larger nodules measuring up to 2 cm in size are noted primarily within all of lobes on the right consistent with tuberculomas.
The findings are in keeping with miliary tuberculosis. The large right hilar mass is likely on the basis of adenopathy however an underlying mass cannot be excluded. Recommend follow-up radiographs to ensure resolution.
Large associated right effusion and on this non-contrast exam an empyema cannot be excluded.