Aspectos tomográficos da consolidação lobar na tuberculose pulmonar primária

Pereira, Bruno Alberto Falcão; Macedo, Solange Gonçalves David De; Nogueira, Rosete; Castiel, Lola Celeste Pantoja; Penna, Cláudia Renata Rezende

doi:10.1590/s0100-39842009000200009

Cited by 2 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In Brazil, lung lesions of less than 3 cm in diameter are likely to be diagnosed as tuberculoma, whereas tuberculous lesions the size of lung masses have rarely been reported and are limited to examples of radiological images. ( 3 - 5 , 14 ) This possibly contributed to our decision to focus on lung cancer in the present case, given that it is quite common in elderly patients with no comorbidities. …”

Section: Discussionmentioning

confidence: 92%

“…Em nosso meio, ao contrário da bem conhecida alta chance de diagnóstico de tuberculoma presente em lesões pulmonares com diâmetro inferior a 3 cm, as lesões com dimensões de massa pulmonar causadas por tuberculose têm sido raramente relatadas e limitadas a exemplos de imagens radiológicas. ( 3 - 5 , 14 ) Esse fato contribuiu, possivelmente, para a decisão dos autores de orientar o presente caso para o enfoque da neoplasia pulmonar, uma situação bem mais presente no quotidiano do médico quando se trata de pacientes idosos e isentos de comorbidades.…”

Section: Discussionunclassified

See 1 more Smart Citation

Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe

et al. 2013

View full text Add to dashboard Cite

Tuberculosis and cryptococcosis are infectious diseases that can result in the formation of single or multiple nodules in immunocompetent patients. Exposure to silica is known to raise the risk of infection with Mycobacterium tuberculosis. We report the case of an elderly man with no history of opportunistic infections and no clinical evidence of immunodeficiency but with a six-month history of dry cough and nocturnal wheezing. A chest X-ray revealed a mass measuring 5.0 × 3.5 cm in the right upper lobe. The diagnostic approach of the mass revealed tuberculosis. The histopathological analysis of the surrounding parenchyma reveled silicosis and cryptococcosis. Cryptococcosis was also found in masses identified in the mediastinal lymph nodes. The surgical approach was indicated because of the degree of pleuropulmonary involvement, the inconclusive results obtained with the invasive and noninvasive methods applied, and the possibility of malignancy. This case illustrates the difficulty inherent to the assessment of infectious or inflammatory pulmonary pseudotumors, the differential diagnosis of which occasionally requires a radical surgical approach. Despite the presence of respiratory symptoms for six months, the first chest X-ray was performed only at the end of that period. We discuss the possible pathogenic mechanisms that might have led to the combination of three types of granulomatous lesions in the same lobe, and we emphasize the need for greater awareness of atypical presentations of pulmonary tuberculosis.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionunclassified

Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe

et al. 2013

View full text Add to dashboard Cite

show abstract

“…2011 Jan/Fev;44(1): [13][14][15][16][17][18][19] (34.3%) of the 35 patients presented ill defined nodules with centrilobular distribution, and 4 (40%) of the 10 patients presented such tomographic finding.…”

Section: Ill Defined Nodules With Centrilobular Distribution (Figure 5)mentioning

confidence: 99%

“…2011 Jan/Fev;44(1): [13][14][15][16][17][18][19] et al (12) have investigated the usefulness of computed tomography (CT) in the differentiation between active and inactive tuberculosis. Pereira et al (13) have described the tomographic findings of primary pulmonary tuberculosis initially manifested as lobar consolidation. In 89 patients with active tuberculosis evaluated with thinslice CT, the following findings were most frequently observed: centrilobular linear opacities (92%), lobular consolidation (62%), acinar nodule (61%), cavity (36%) and ground glass opacity (35%).…”

Section: Introductionmentioning

confidence: 99%

Aspectos tomográficos da tuberculose pulmonar em pacientes adultos com AIDS

et al. 2011

View full text Add to dashboard Cite

Objective: The present study is aimed at describing computed tomography findings pulmonary tuberculosis in adult AIDS patients assisted at a radiology unit of a reference infectious diseases hospital, in an attempt to establish the association between such findings and CD4 count. Materials and Methods: Forty-five patients were evaluated by chest computed tomography over a four-year period. Results: Mediastinal and/or hilar lymph node enlargement was found in 31 (68.8%) cases, pleural effusion in 29 (64.4%), centrilobular nodules with segmental distribution in 26 (57.7%), consolidation in 24 (53.3%), confluent micronodules in 17 (37.7%), poorly defined nodules with centrilobular distribution in 16 (35.5%), tree-in-bud pattern in 13 (28.9%), bronchial wall thickening in 12 (26.6%), thick-walled cavity in 10 (22.2%), miliary nodules in 9 (20%), and cylindrical bronchiectasis in 6 (13.3%). Among the 45 patients, 35 (77.8%) presented CD4 count < 200 cel/mm 3 and 10 (22.2%) presented CD4 count ≥ 200 cel/mm 3 . Conclusion: Differently from reports in the literature, the authors conclude that mediastinal and/or hilar lymph node enlargement and consolidation were significantly most frequent in patients with CD4 count ≥ 200 cel/mm 3 . However, lymph nodes with hypodense center were most often observed in severely immunosuppressed patients with CD4 count < 200 cel/mm 3 . Keywords: Tuberculosis; Tomography; Chest; HIV; AIDS; SIDA.Objetivo: Este trabalho tem como finalidade descrever os achados tomográficos da tuberculose pulmonar em pacientes adultos com AIDS atendidos no serviço de radiologia de um hospital de referência em doenças infecciosas, procurar associações desses achados e a contagem de CD4. Materiais e Métodos: Foram estudados 45 pacientes por meio de tomografia computadorizada de tórax durante quatro anos. Resultados: Foram encontrados linfonodomegalia mediastinal e/ou hilar em 31 (68,8%) dos casos, derrame pleural em 29 (64,4%), nódulos centrolobulares de distribuição segmentar em 26 (57,7%), consolidação em 24 (53,3%), confluência de micronódulos em 17 (37,7%), nódulos mal definidos com distribuição centrolobular em 16 (35,5%), padrão de "árvore em brotamento" em 13 (28,9%), espessamento de parede brônquica em 12 (26,6%), cavidade de parede espessa em 10 (22,2%), nódulos miliares em 9 (20%) e bronquiectasias cilíndricas em 6 (13,3%). Dos 45 pacientes, 35 (77,8%) apresentaram CD4 < 200 cel/mm 3 e 10 (22,2%) apresentaram CD4 ≥ 200 cel/mm 3 . Conclusão: Concluímos que neste estudo, diversamente do descrito na literatura, linfonodomegalia mediastinal e/ou hilar e consolidação foram significativamente mais frequentes em pacientes com CD4 ≥ 200 cel/mm 3 . No entanto, linfonodos com centro hipodenso foram mais frequentemente observados em pacientes com severa imunodepressão, ou seja, CD4 < 200 cel/mm 3 . Unitermos: Tuberculose; Tomografia; Tórax; HIV; AIDS; SIDA. AbstractResumo

show abstract

Aspectos tomográficos da consolidação lobar na tuberculose pulmonar primária

Cited by 2 publications

References 12 publications

Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe

Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe

Aspectos tomográficos da tuberculose pulmonar em pacientes adultos com AIDS

Contact Info

Product

Resources

About