Post primary tuberculosis

Case contributed by Dr Tomas Jurevicius

Presentation

A 56 year-old male patient presented with persistent dry cough and fever.

Patient Data

Age: 56
Gender: Male
Modality: CT

No evidence of pleural effusion.

Multiple well defined low density nodules in the right lung with calcification and no enhancement.

Some nodules connected with bronchi - evidence suggest granulomas. Around these nodules are see multiple small centrilobular nodules and the appearance of "tree in bud" - a sign of endobronchial spread.

Several granulomas in the left lung with several centrilonular nodules around.

Multiple mediastinal and axillary lymph nodes with no sign of necrosis, some with calcification.

Conclusion: signs of granulomatous disease with possible relapse, data suggest mycobacterial infection.

Case Discussion

The patient was initially treated for tuberculosis. Bronchial washings smear for acid-fast bacilli (AFB) was positive and cultures were negative.

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Case Information

rID: 42899
Case created: 14th Feb 2016
Last edited: 20th Feb 2016
System: Chest
Inclusion in quiz mode: Included

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