Radiological features of pulmonary tuberculosis in elderly patients

We reviewed the radiological findings in 55 hospital inpatients aged 60 and over with bacteriologically proven tuberculosis over a 5-year period 1981-5. Since most of the patients were infected during childhood it was expected that the majority would show the 'typical' findings of post-primary disease with apicoposterior lung lesions. This was found in 43 of the patients (78%). Unusual features were found in 12 patients: solitary pleural effusion (1), miliary tuberculosis (2), tuberculoma (1), isolated mediastinal or hilar lymphadenopathy (1), solitary ventrobasal and middle-lobe or lingular lesions (7). No major differences were found in comparison with a group of 59 younger patients with proven pulmonary tuberculosis. Amongst these 15 (25%) had 'atypical' radiological findings. We conclude that the radiological manifestations of pulmonary tuberculosis in elderly patients do not differ in frequency or distribution from those seen in younger adults.