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[Tuberculosis of the lung bases]
K Ben Miled-M'rad1, M Kara, S Hantous-Zannad
1Service d'Imagerie Médicale, CHU Abderrahmen Mami, Ariana, Tunisie. khaoula.mrad@rns.tn
Revue Des Maladies Respiratoires
|June 1, 2002
Summary
Basal tuberculosis, a rare lung condition, often mimics other diseases, leading to diagnostic delays. CT scans showing alveolar consolidation with specific nodules and masses can suggest this diagnosis, aiding timely treatment.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) of the lung bases is uncommon and can be misdiagnosed as pneumonia, lung abscess, or bronchiectasis.
- Diagnostic delays in basal TB are frequent due to negative bacteriological examinations, potentially leading to unresectable complications.
Purpose of the Study:
- To describe the clinical and radiological features of basal tuberculosis.
- To evaluate the utility of computed tomography (CT) in diagnosing this rare form of TB.
Main Methods:
- Retrospective analysis of 10 cases of basal tuberculosis diagnosed between 1993 and 1998.
- Review of chest X-rays and CT scans.
- Correlation with bronchoscopy findings in some cases.
Main Results:
- Chest X-rays typically showed heterogeneous opacity.
- CT scans revealed alveolar consolidation, often with centrilobular micronodules, cavitated nodules, and masses.
- Absence of apical lesions and frequent mediastinal/bronchial lymph node involvement were noted.
- Bronchoscopy identified endobronchial lesions in a high incidence of cases.
Conclusions:
- Basal tuberculosis presents with distinct radiological findings on CT scans.
- The pattern suggests bronchial dissemination from tuberculous lymph nodes.
- CT imaging, combined with bronchoscopy, is crucial for diagnosing this rare manifestation of TB, especially when bacteriology is negative.