Pulmonary tuberculosis in patients with emphysema: Computed tomography findings

Kyung Nyeo Jeon, Ji Young Ha, Mi Jung Park, Kyungsoo Bae, Hye Jin Baek, Bo Hwa Choi, Soo Buem Cho, Jin Il Moon, Ho Cheol Kim

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective: To evaluate the computed tomography (CT) findings and clinical characteristics of pulmonary tuberculosis (TB) in patients with emphysema, compared with those without emphysema. Materials and Methods: Thirty-nine patients (M:F = 36:3; mean age, 64.8 years) who were diagnosed with chronic obstructive pulmonary disease and had emphysema in pretreatment chest CT scans were included in this study (emphysema group). Their clinical presentation, laboratory findings, and CT findings were compared with those of 57 pulmonary TB patients without chronic obstructive pulmonary disease and emphysema (M:F = 52:5; mean age, 64.3 years) (nonemphysema group). Results: Fever was a more frequent clinical presentation and the C-reactive protein level was higher in the emphysema group. Among CT findings, consolidation and ground-glass opacity were seen more frequently in the emphysema group (82% and 69% vs 42% and 19%, respectively, P < 0.001). Consolidation was more often nonsegmental than lobular or segmental. Tree-in-bud appearance was less frequently noted in the emphysema group (36% vs 79%, P < 0.001). The location of main lesions (upper lung vs middle/lower lung) was not different between the 2 groups. Conclusions: Pulmonary TB in emphysema patients often shows bacterial pneumonia-like features, that is, presence of consolidation and ground-glass opacity and lack of bronchogenic spread on chest CT scans, combined with the presence of fever and a high C-reactive protein level. Sputum smear for acid-fast bacteria should be performed early in emphysema patients with pneumonia in TB-endemic areas.

Original languageEnglish
Pages (from-to)912-916
Number of pages5
JournalJournal of Computer Assisted Tomography
Volume40
Issue number6
DOIs
StatePublished - 2016

Keywords

  • COPD
  • CT
  • Computed tomography
  • Pulmonary emphysema
  • Tuberculosis

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