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Pulmonary Tuberculosis in Infants: Radiographic and CT Findings

Woo Sun Kim1, Joon-Il Choi1,2, Jung-Eun Cheon1, In-One Kim1, Kyung Mo Yeon1 and Hoan Jong Lee3

1 Department of Radiology, Seoul National University College of Medicine Institute of Radiation Medicine, SNUMRC (Seoul National University Medical Research Center), Seoul, Korea.
2 Present address: Department of Radiology, National Cancer Center, 809 Madu-I-dong, Islan dong-gu, Goyang-si, Gryeonggi-do, Korea.
3 Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.


Figure 1
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  		Fig. 1A —4-month-old girl with pulmonary tuberculosis (patient 15). Masslike consolidation and bronchial obstruction caused by hilar lymphadenopathy. Chest radiograph shows consolidation in right lower lung zone (asterisk) and widening of right upper mediastinum (arrows).

 

Figure 2
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  		Fig. 1B —4-month-old girl with pulmonary tuberculosis (patient 15). Masslike consolidation and bronchial obstruction caused by hilar lymphadenopathy. Enhanced CT scan shows well-defined, well-enhancing, masslike consolidation in right lower lobe (asterisk). Note low-attenuation lymphadenopathy (arrow) obstructing bronchus intermedius.

 

Figure 3
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  		Fig. 1C —4-month-old girl with pulmonary tuberculosis (patient 15). Masslike consolidation and bronchial obstruction caused by hilar lymphadenopathy. CT scan in lower level of image seen in B shows large consolidation in right middle lobe and right lower lobe. Consolidation is slightly volume expanding. There are multiple low-attenuation areas (arrows) in consolidation area.

 

Figure 4
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  		Fig. 2 —6-month-old boy with pulmonary tuberculosis (patient 10). Large cavity within consolidation. Chest radiograph shows large cavity within consolidation in right upper lobe (arrow). Multiple nodules are seen in left upper lung field (arrowheads).

 

Figure 5
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  		Fig. 3A —4-month-old girl with systemic disseminated tuberculosis (patient 12). Chest radiograph shows multiple disseminated nodules in both lungs and consolidation in left lower lung zone (asterisk).

 

Figure 6
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  		Fig. 3B —4-month-old girl with systemic disseminated tuberculosis (patient 12). Chest CT scan shows disseminated nodules of variable size. Most nodules are larger than 2 mm in diameter.

 

Figure 7
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  		Fig. 3C —4-month-old girl with systemic disseminated tuberculosis (patient 12). Enhanced CT scan shows consolidation with low-attenuation area (arrows) within it in superior segment of left lower lobe.

 

Figure 8
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  		Fig. 3D —4-month-old girl with systemic disseminated tuberculosis (patient 12). Numerous low-attenuation nodules are noted in spleen on enhanced CT scan.

 

Figure 9
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  		Fig. 4A —4-month-old boy with acute disseminated tuberculosis (patient 14). Cavitary changes in nodules are seen. Chest radiograph shows numerous nodules in both lungs. Thin-walled cavity (arrows) is seen in left lower lobe.

 

Figure 10
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  		Fig. 4B —4-month-old boy with acute disseminated tuberculosis (patient 14). Cavitary changes in nodules are seen. On chest CT, multiple variable-sized nodules are detected. Cavity formation in some nodules is noted (arrows).

 

Figure 11
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  		Fig. 4C —4-month-old boy with acute disseminated tuberculosis (patient 14). Cavitary changes in nodules are seen. Follow-up chest radiograph obtained 1 year after A and B shows no parenchymal nodule in either lung.

 

Figure 12
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  		Fig. 5A —3-month-old boy (patient 1) with acute disseminated tuberculosis. Chest radiograph shows multiple disseminated nodules with random distribution in both lungs.

 

Figure 13
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  		Fig. 5B —3-month-old boy (patient 1) with acute disseminated tuberculosis. Chest CT scan shows multiple small nodules in both lungs.

 

Figure 14
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  		Fig. 5C —3-month-old boy (patient 1) with acute disseminated tuberculosis. On follow-up chest radiograph obtained after antituberculosis medication for 1 year, nodules are healed, leaving multiple calcifications. Note multiple calcifications in spleen (arrows).

 

Figure 15
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  		Fig. 6A —5-month-old girl (patient 2) with bronchogenic spread of tuberculosis and bronchial stenosis. Chest radiograph shows left hilar bulging (white arrow) and hyperinflation of left lung. Note narrowing of left main bronchus (black arrows).

 

Figure 16
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  		Fig. 6B —5-month-old girl (patient 2) with bronchogenic spread of tuberculosis and bronchial stenosis. High-resolution CT scan reveals peribronchial infiltrations and peripheral small nodules (arrows) suggesting bronchogenic spread of tuberculosis in left upper lobe. Hyperinflation of left lung is also noted.

 

Figure 17
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  		Fig. 6C —5-month-old girl (patient 2) with bronchogenic spread of tuberculosis and bronchial stenosis. CT scan shows narrowing of left main bronchus (black arrows) by enlarged subcarinal lymph nodes (white arrow).

 

Figure 18
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  		Fig. 6D —5-month-old girl (patient 2) with bronchogenic spread of tuberculosis and bronchial stenosis. Segmental bronchi (white arrow) of left upper lobe are also stenosed by hilar lymph nodes (asterisk). Note enlarged subcarinal lymph node with central low attenuation (black arrows).

 

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