High resolution computed tomographic patterns in adults with pulmonary tuberculosis.

OBJECTIVE To determine the High Resolution Computed Tomographic (HRCT) patterns in adults with Acid Fast Bacillus (AFB) positive new cases of Pulmonary Tuberculosis (PTB). STUDY DESIGN A descriptive case series. PLACE AND DURATION OF STUDY The study was carried out at the Department of Pulmonology and Department of Radiology, Military Hospital, Rawalpindi, from June 2006 to August 2007. METHODOLOGY Fifty adults with AFB positive new pulmonary tuberculosis were included in the study, while PTB cases in the retreatment category, Multi Drug Resistant (MDR) tuberculosis, PTB with Chronic Obstructive Airways Disease (COPD), pneumoconiosis, Diffuse Parenchymal Lung Diseases (DPLDs) etc. were excluded. All cases underwent HRCT chest with 2 mm collimations at 10 mm intervals. Relevant data was collected on a pre-designed patient proforma. RESULTS The mean age was 40.18 +/- 14.55 years with 88% males; 46% and 30% samples were sputum and endobronchial washings smear positive for AFB respectively, while the rest were culture positive. HRCT findings included centrilobular nodules in 92% cases, lobular consolidation in 84%, cavitation in 76%, 'tree-in-bud' appearance in 68%, lymphadenopathy in 8% and miliary nodules in 4% cases. HRCT patterns included centrilobular nodules and lobular consolidation in 80% cases, while centrilobular nodules with cavitation and centrilobular nodules with 'tree-in-bud' appearance were noted in 72% and 68% patients respectively. Thirty two (64%) cases had centrilobular nodules, cavitation and lobular consolidations and about half cases had centrilobular nodules, 'tree-in-bud' appearance and lobular consolidation. CONCLUSION Centrilobular nodules and lobular consolidations (80%), centrilobular nodules with cavitation (72%) and centrilobular nodules with 'tree-in-bud' appearance (68%) were the most common HRCT patterns in adults newly diagnosed with pulmonary tuberculosis.