Post primary tuberculosis
A 56 year-old male patient presented with persistent dry cough and fever.
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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.
The patient was initially treated for tuberculosis. Bronchial washings smear for acid-fast bacilli (AFB) was positive and cultures were negative.