[Interstitial (lymphogenous) disseminated pulmonary tuberculosis: diagnostic capacities of computed tomography]

Computed tomography (CT) as a priority radiation diagnostic technique for interstitial lung diseases was used to examine 35 patients with disseminated interstitial lymphogenous tuberculosis (ILT). Individuals having ILT amounted to 29% of the total number of the patients with disseminated pulmonary tuberculosis. The major CT markers of ILT are interstitial diffuse bilateral lesion with the reticular or reticulonodular macrostructure. ILT is characterized by its lymphogenous origin with involvement of the superficial and peripheral lymphatic network, by a productive inflammatory reaction showing no tendency to consolidation and cavernization, by none or meager bacterial isolation, by a negative or insignificant tuberculin sensitivity, as well as by difficulties in the identification of a granulomatous component. In terms of the level of damage to the interstitial structures, ILT presented with predominant intralobular interstitial lesion as small reticularity in 16% of the patients, with predominant intralobular interstitial lesion as large reticularity in 59%, and with predominant peribronchovascular interstitial lesion in 25%. The identified CT types of ILT are noteworthy for a chemotherapeutic approach and its results and for the degree of development of interstitial fibrosis.