Pulmonary tuberculosis after hematopoietic stem cell transplantation: radiologic findings

To determine the radiologic features of pulmonary tuberculosis in hematopoietic stem cell transplant (HSCT) recipients.

Between January 1996 and December 2005, 10 patients with pulmonary tuberculosis were analyzed. Chest radiographs were available in all of these patients and chest computed tomography (CT) scans were available in 7 patients. We retrospectively analyzed each patient's chest radiographic and CT findings.

On chest radiography (n=10), the most common abnormalities were air-space consolidation (100%) and nodules (80%). Parenchymal lesions appeared mixed with other findings (80%). The most common mixed pattern was nodules with consolidations (80%). Parenchymal lesions were multilobar (80%), patchy (70%), or bilateral (80%). Evidence of a zonal predominance was not seen. On chest CT scans (n=7), the most common parenchymal lesions were consolidation (100%), nodules (71%), tree-in-bud appearance (43%), and ground-glass opacity (43%). Parenchymal lesions seen on CT scans also appeared mixed (86%) and multilobar in distribution (100%). Significant zonal predominance was not noted on CT scans. Cavity was noted in 14% of the study patients and lymphadenopathy was noted in 71% of these patients on CT scans.

The radiologic features of pulmonary tuberculosis in HSCT recipients were nodules or air-space consolidation. Most of the abnormalities were mixed with other findings and had multilobar distribution, however, a lobar predilection was not seen. Awareness of radiologic findings of pulmonary tuberculosis in HSCT recipients may help the diagnosis of pulmonary tuberculosis.