0
Original Research: Chest Infections |

Pulmonary Changes of Pleural TBPulmonary Changes of Pleural TB: Up-to-Date CT Imaging

Jeong Min Ko, MD; Hyun Jin Park, MD; Chi Hong Kim, MD
Author and Funding Information

From the Department of Radiology (Drs Ko and Park), and the Department of Internal Medicine (Dr Kim), St. Vincent’s Hospital, The Catholic University of Korea, Suwon-si, South Korea.

CORRESPONDENCE TO: Hyun Jin Park, MD, Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, 93 Ji-dong, Paldal-gu, Suwon-si, Kyeonggi-do, 403-720, South Korea; e-mail: radiodoc@catholic.ac.kr


FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(6):1604-1611. doi:10.1378/chest.14-0196
Text Size: A A A
Published online

BACKGROUND:  The objective of this study was to evaluate pulmonary abnormalities of pleural TB by CT scanning and to determine CT scan findings for the development of the paradoxical response (PR).

METHODS:  CT scans were performed for 349 patients with pleural TB (between 2008 and 2013). We excluded 34 patients with coexisting pulmonary disease (n = 13) or a totally collapsed lung (n = 21). We analyzed CT scans focusing on pulmonary abnormalities such as the presence of consolidation, cavitation, interlobular septal thickening, and micronodules and their distribution. In addition, we recorded the development of PR during follow-up and statistically analyzed differences in clinical and CT scan findings between patients with and without PR.

RESULTS:  A total of 270 of 315 patients (86%) had pulmonary abnormalities. Common CT scan findings were micronodules (n = 209 [77%]), interlobular septal thickening (n = 202 [75%]), and consolidation (n = 120 [44%]). Cavitation was seen in 49 patients (18%). Among 209 with micronodules, the nodules were in the subpleural region (n = 146 [70%]), peribronchovascular interstitium (n = 113 [54%]), and centrilobular region (n = 64 [31%]). PR occurred in 81 patients (26%), and patients with PR tended to be young, male, and without underlying disease (P < .05 by t test, Pearson χ2 test). Subpleural micronodules were more common in patients with PR than in those without PR (Pearson χ2, P = .025).

CONCLUSIONS:  Pulmonary abnormalities are very common in pleural TB. The most common CT scan findings were micronodules in the subpleural and peribronchovascular interstitium and interlobular septal thickening, suggesting the lymphatic spread of TB. In addition, PR is not rare in patients with pleural TB, especially in young, previously healthy, male patients who show subpleural nodules on initial CT scans.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543