Tuberculous pericardial calcifications
Past medical history of tuberculosis (TB) treated in 2013, presenting with cough, fatigue and one episode of hemoptysis. Chest x-ray evaluation for recurrent tuberculosis.
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No new focal pneumonia, effusion or pneumothorax. Mild diffuse bilateral peribronchial thickening.
Stable right upper lobe scarring with adjacent pleural thickening/reaction consistent with history of tuberculosis. No evidence of active TB.
The heart remains normal sized without pulmonary vascular congestion.
Almost diffuse curvilinear/circumferential pericardial calcification.
No acute osseous findings.
Tuberculous pericarditis is frequently reported as the primary cause of pericardial calcification 1 and occurs in approximately 1 to 2 percent of patients with pulmonary tuberculosis (TB). This is a rare finding in the Western World. However, tuberculous pericarditis accounts for nearly 10% of chronic constrictive pericarditis cases in the United States 2. There is strong evidence that large calcific pericardial deposits indicate “burnt-out” pericardial tuberculosis 2. Detecting the pericardial calcification on radiography is important for definitive diagnosis 2.
The differential diagnosis for pericardial calcifications include 1:
- cardiac surgery
- connective tissue disorders
This case was submitted with supervision and input from:
Soni C. Chawla, M.D.
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center
- 1. Incidental findings of pericardial calcification. (2014) World Journal of Clinical Cases. 2 (9): 455. doi:10.12998/wjcc.v2.i9.455 - Pubmed
- 2. Yetkin U, Ilhan G, Calli AO, Yesil M, Gurbuz A. Severe calcific chronic constrictive tuberculous pericarditis. (2008) Texas Heart Institute journal. 35 (2): 224-5. Pubmed