Post primary pulmonary tuberculosis

Case contributed by Sakher Alkhaderi
Diagnosis certain

Presentation

Cough, fever, malaise

Patient Data

Age: 55 years
Gender: Female

Typical distribution of ill-defined patchy consolidation with cavity formation and extensive endobronchial spread more in the right upper lobe and the apical segment of the right lower lobe, the images clearly depicts the tree-in-bud appearance and peribronchial thickening throughout the lung as well as multiple right hilar and pre-tracheal lymphadenopathy.

Case Discussion

Post-primary infections are far more likely to cavitate than primary infections and are seen in 20-45% of cases, in the vast majority of cases they develop in the posterior segment of the upper lobes  (85%), endobronchial spread is a common finding resulting in tree-in-bud appearance.

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