Pulmonary tuberculosis

Case contributed by RMH Report Writing

Presentation

Sudanese, 10kg weight loss, several bouts of haemoptysis and ongoing fevers.

Patient Data

Age: 24-year-old
Gender: Male

Chest radiograph

Modality: X-ray

The lungs are clear, there is no pulmonary nodule or infiltrate identified, the pleural spaces are normal. There is mediastinal widening and large hilar lymph nodes bilaterally.

The heart size and shape is within normal limits.

Conclusion: There are changes of extensive mediastinal and hilar lymphadenopathy identified. CT scan of the thorax is indicated.

CT Chest

Modality: CT

Multiple enlarged mediastinal and hilar lymph nodes are seen forming large conglomerate masses. The larger nodal components measure 30 x 37 x60 mm within the right paratracheal region and 36 x25 x50 mm within the subcarinal region. There also enlarged axillary lymph nodes measuring up to 1 cm in short axis.

Numerous nodules are also demonstrated in the lungs bilaterally measuring up to 5 mm in size. Some nodules are of perilymphatic distribution with evidence of fissural nodularity. There is no cavitation. No zonal predominance. No pleural or pericardial effusion.

Limited views of the upper abdominal viscera appear within normal limits. No suspicious osseous lesions.

Conclusion: Extensive lymphadenopathy is seen in the presence of numerous pulmonary nodules of perilymphatic distribution most consistent TB or lymphoma.

Case Discussion

Transbronchial biopsy was diagnostic for TB

This case illustrates extensive mediastinal lymphadenopathy with central low attenuation. 

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Case Information

rID: 38167
Case created: 9th Jul 2015
Last edited: 12th Nov 2016
System: Chest
Tag: rmh
Inclusion in quiz mode: Included

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