Extrapulmonary Tuberculosis: Pathophysiology and Imaging Findings

Area of Science:

• Radiology
• Infectious Diseases
• Medical Imaging

Background:

• Extrapulmonary tuberculosis (TB) accounts for about 15% of all TB cases.
• Diagnosis is often difficult due to non-specific clinical and imaging findings, frequently necessitating biopsy.
• Radiologists play a key role in identifying extrapulmonary TB, especially in high-risk patients.

Purpose of the Study:

• To highlight the diverse imaging manifestations of extrapulmonary TB.
• To emphasize the importance of recognizing imaging features for diagnosis.
• To guide radiologists in identifying extrapulmonary TB in various organ systems.

Main Methods:

• Review of imaging findings in extrapulmonary TB across different organ systems.
• Correlation of imaging features with clinical presentations and patient immune status.
• Emphasis on characteristic findings in frequently affected sites like the lymphatic system and musculoskeletal system.

Main Results:

• The lymphatic system is the most commonly affected site in extrapulmonary TB.
• Necrotic lymph nodes and organ-specific features aid diagnosis.
• Immunosuppressed patients commonly present with disseminated disease and CNS involvement.
• Renal TB can occur in immunocompetent individuals after long latency.
• Tuberculous spondylitis and articular disease are common musculoskeletal manifestations.

Conclusions:

• Recognizing varied imaging findings is essential for diagnosing extrapulmonary TB.
• Early identification of extrapulmonary TB improves patient outcomes.
• Radiologists must be vigilant for extrapulmonary TB manifestations, even without concurrent pulmonary disease.