X-Ray: Miliary Tuberculosis
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Transcript of X-Ray: Miliary Tuberculosis
-Dr. Prof. TITO’s Unit
Dr. Pandichelvan R.
-Most commonly manifest as post primary TB rather than Primary TB in older patients
-Purely Nodular Pattern in febrile patient with acute presentation suggestive of hematogenous infection, particularly miliary TB.
-Radiological evidence usually takes several weeks to appear.
MILIARY TUBERCULOSIS
Imaging FindingsDiscrete Distinctive Pin-point opacities WHY NODULARITY?
Nodule size 1 – 2 mm in diameter -SPHERICAL LESION IN
Miliary ( millet seed ) Pattern INTERSTITIUM
B/L even distribution -WELL CIRCUMSCRIBED
Basal Predominance HOMOGENOUS PATTERN
Rare or non-existent calcifications
Upto 30 % no radiological signs
Thickening of intralobar fissure / interlobular septa
Nodular irregularity of vessels
HRCT – more sensitive
Differential diagnosisPNEUMOCONIOSIS
- Coal Workers Pneumoconiosis- Silicosis- Siderosis- Stannosis
SARCOIDOSIS
METASTATIC LUNG DISEASES
NON TB INFECTIONS- Histoplasmosis- Blastomycosis- Cryptococcosis- Nocardiosis- Coccidiodomycosis
BRONCHIOLITIS OBLITERANS
SILICOSIS :
Multiple well circumscribed nodules
Uniform density
Upper lobe predominance
Mainly posterior lobe
Nodular Calcification seen in 10 – 20 % cases
Hilar lymphadenopathy
Egg Shell Calcification
:
COAL WORKERS PNEUMOCONIOSIS:
Simple Pneumoconiosis
small round nodule 1 – 5mm
granular densities
calcifications begin as central dot
Complicated Pneumoconiosis
large opacities > 1cm
upper lung zones
start peripherally
Metastatic Lung Disease75% -multiple pulmonary nodules
B/L with basal predominance
peripheral lesions ( subpleural )
cavitatory lesions
squamous carcinomas
sarcomas
calcification rare ,except in
osteogenic sarcoma
chondrosarcoma
mucinous adenocarcinoma
SARCOIDOSISB/L symmetrical diffuse pulmonary
disease
B/L Hilar lymphadenopathy
Upper zone mainly
Imaging Patterns:
m/c nodular
reticulo-nodular
reticular pattern
(rare) air space consolidaton
ground glass opacification