Abstract
To evaluate in chest X-ray and high resolution computed tomography (HRCT) of patients with pleural tuberculosis (PT), the incidence of lung lesions suggestive of active disease.
Methods: Prospective study evaluating radiological abnormalities of 88 patients with PT. The images reviewed by three independent specialists were classified according to previously established criteria: 1) Disease activity (presence of consolidation, thick-walled cavity, centrilobular or confluent nodules, and tree-in-bud pattern); 2) Nonspecific findings (solitary nodules, lymphadenomegaly, cylindrical bronchiectasis, and bronchial wall thickening) and, 3) Signs of residual scarring (parenchymal fibrotic bands and traction bronchiectasis). The results were expressed as the frequency of each observed radiological finding.
Results: All patients presented unilateral pleural effusion. Abnormal changes were observed in chest X-ray of 22 (25%) patients and in HRCT of 55 (63%). Images compatible with active pulmonary tuberculosis were detected by chest X-ray in 9 (10%) patients and by HRCT in 38 (43%). Centrilobular nodules (30.7%), confluent nodules (27.3%) and tree-in-bud pattern (10.2%) were only detected by HRCT. The presence of solitary nodules and lymphadenomegaly were more frequently detected by HRCT. Only four patients presented tomographic images suggestive of residual disease.
Conclusion: The present study demonstrates that pulmonary involvement is quite common in pleural tuberculosis and that the lesions were mainly detected by HRCT. These findings have epidemiological implications, since patients with pleural tuberculosis should be considered as potential sources of disease infection and spread.
- © 2011 ERS
