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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
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Tree-in-Bud Pattern of Pulmonary Tuberculosis on Thin-Section CT: Pathological Implications.

Jung-Gi Im1,2, Harumi Itoh3

  • 1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea.

Korean Journal of Radiology
|September 4, 2018
PubMed
Summary

The tree-in-bud pattern on CT scans represents inflammation in lung bronchioles and alveolar ducts. This pattern, seen in tuberculosis, involves inflammatory filling of these structures, not lymphatic involvement.

Keywords:
Centrilobular nodulesCluster of micronodulesPulmonary tuberculosisRadiology-Pathology correlationTree-in-bud

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Pathology

Background:

  • The "tree-in-bud pattern" on thin-section lung CT scans is characterized by centrilobular branching structures resembling a budding tree.
  • Understanding the pathological basis of this imaging finding is crucial for accurate diagnosis.

Purpose of the Study:

  • To investigate the pathological basis of the tree-in-bud lesion observed in lung imaging.
  • To correlate radiological findings with pathological specimens in cases of pulmonary tuberculosis.

Main Methods:

  • Review of pathological specimens from bronchograms of normal lungs.
  • Examination of contract radiographs of post-mortem lungs with active pulmonary tuberculosis.
  • Radiological and pathological correlation to define the components of the tree-in-bud pattern.

Main Results:

  • The "tree" component corresponds to the intralobular inflammatory bronchiole.
  • The "bud" component represents inflammatory material filling alveolar ducts, which are larger than the bronchioles.
  • Clusters of micronodules observed in tuberculosis radiographs were identified as clusters of tree-in-bud lesions within secondary pulmonary lobules.
  • No evidence of lung parenchymal lymphatic involvement was found in the studied specimens.

Conclusions:

  • The tree-in-bud pattern is pathologically defined by inflammation of bronchioles and alveolar ducts.
  • This pattern is a key radiological manifestation in pulmonary tuberculosis.
  • The study clarifies the anatomical structures corresponding to the tree-in-bud imaging finding.