Tuberculosis Beyond the Lungs: A Pictorial Review of Key Diagnostic Imaging Insights

Tuberculosis (TB) remains a significant global health challenge, traditionally associated with pulmonary manifestations. However, extrapulmonary tuberculosis (EPTB) accounts for a substantial portion of TB cases, particularly in immunocompromised patients. EPTB can affect virtually any organ system and often mimics other infectious, inflammatory, or neoplastic conditions, making diagnosis particularly challenging. This pictorial review aims to illustrate the broad spectrum of imaging findings in EPTB using selected, confirmed cases involving hepatic, splenic, adrenal, pancreatic, genitourinary, lymphatic, gastrointestinal, cardiovascular, musculoskeletal, and central nervous system sites. Magnetic resonance imaging (MRI) and computed tomography (CT) are highlighted for their diagnostic capabilities, with MRI offering superior soft tissue contrast and CT providing high-resolution evaluation of organ involvement and guiding tissue sampling. Each case presented is supported by microbiological, histopathological, or molecular confirmation, reinforcing the importance of correlating radiologic features with definitive diagnostic tools. By enhancing familiarity with the diverse radiologic appearances of EPTB, this review seeks to improve diagnostic confidence and facilitate timely clinical decision-making in complex cases.