Pulmonary tuberculosis

Case contributed by Dr Bruno Di Muzio


Subacute history of cough for three months.

Patient Data

Age: 60 years
Gender: Female

CT Chest


There are thick-walled cavities with an extensive endobronchial spread characterized by tree-in-bud pattern and centrilobular nodules.

Case Discussion

The lungs are the most common site of primary infection by tuberculosis and are a major source of spread of the disease and of individual morbidity and mortality. 

This case is assumed to be post-primary tuberculosis.

The features of primary and post-primary tuberculosis may overlap; however, some imaging distinguishing features of post-primary tuberculosis include a predilection for the upper lobes, the absence of lymphadenopathy, and cavitation 1

Cavitation, the hallmark of post-primary tuberculosis, affects about 50% of patients. The cavities typically have thick, irregular walls, which become smooth and thin with successful treatment. Cavities are usually multiple and occur within areas of consolidation 1.

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