X-Ray: Miliary Tuberculosis
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X-Ray: Miliary Tuberculosis

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X-Ray: Miliary Tuberculosis X-Ray: Miliary Tuberculosis Presentation Transcript

            • Dr. Prof. TITO’s Unit
    • Dr. Pandichelvan R .
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    • Most commonly manifest as post primary TB rather than Primary TB in older patients
    • Purely Nodular Pattern in febrile patient with acute presentation suggestive of hematogenous infection, particularly miliary TB.
    • Radiological evidence usually takes several weeks to appear.
    MILIARY TUBERCULOSIS
  • Imaging Findings Discrete Distinctive Pin-point opacities WHY NODULARITY? Nodule size 1 – 2 mm in diameter - SPHERICAL LESION IN Miliary ( millet seed ) Pattern INTERSTITIUM B/L even distribution - WELL CIRCUMSCRIBED Basal Predominance HOMOGENOUS PATTERN Rare or non-existent calcifications Upto 30 % no radiological signs Thickening of intralobar fissure / interlobular septa Nodular irregularity of vessels HRCT – more sensitive
  • Differential diagnosis PNEUMOCONIOSIS - Coal Workers Pneumoconiosis - Silicosis - Siderosis - Stannosis SARCOIDOSIS METASTATIC LUNG DISEASES NON TB INFECTIONS - Histoplasmosis - Blastomycosis - Cryptococcosis - Nocardiosis - Coccidiodomycosis BRONCHIOLITIS OBLITERANS
  • SILICOSIS : Multiple well circumscribed nodules Uniform density Upper lobe predominance Mainly posterior lobe Nodular Calcification seen in 10 – 20 % cases Hilar lymphadenopathy Egg Shell Calcification :
  • COAL WORKERS PNEUMOCONIOSIS: Simple Pneumoconiosis small round nodule 1 – 5mm granular densities calcifications begin as central dot Complicated Pneumoconiosis large opacities > 1cm upper lung zones start peripherally
  • Metastatic Lung Disease 75% -multiple pulmonary nodules B/L with basal predominance peripheral lesions ( subpleural ) cavitatory lesions squamous carcinomas sarcomas calcification rare ,except in osteogenic sarcoma chondrosarcoma mucinous adenocarcinoma
  • SARCOIDOSIS B/L symmetrical diffuse pulmonary disease B/L Hilar lymphadenopathy Upper zone mainly Imaging Patterns : m/c nodular reticulo-nodular reticular pattern (rare) air space consolidaton ground glass opacification
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