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홍지영
2
92
sputum Cx 상 결핵 확진된 분으로 처음에 결핵을 의심하지 않게 되는 interstitial pattern 이라 올려 보았습니다.
결핵의
ATYPICAL CT FINDINGS입니다.
1. Single or Multiple Nodules or Masses
2.Basilar Infiltrates
3.Miliary Tuberculosis with an Atypical Pattern
4. Reversible Multiple Cysts
이번 case 는 세번째 case 와 영상학적으로 유사해 보입니다.
Miliary tuberculosis presenting as acute respiratory failure in a 69-year-old man. A high-resolution CT scan (1-mm collimation) obtained at the level of the bronchus intermedius shows randomly distributed 1-to 3-mm micronodules. Note diffuse areas of ground-glass opacity and peribronchiolar consolidation in both lungs. Also note interlobular septal thickening. [Reprinted with permission from Choi et al.
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Sometimes many small nodules distributed randomly with associated diffuse bilateral areas of ground-glass opacity on CT are seen in patients with pulmonary tuberculosis Biopsy shows permeability edema consisting of hyperplasia of type II pneumocytes, fibrin material admixed with inflammatory cells in the alveolar space, and
loose myxoid fibroblastic proliferation in the alveolar
walls.
These are associated with
epithelioid
granulomas with central caseation necrosis along the alveolar walls, bronchovascular bundles, and subpleural interstitium.
References
Pulmonary Tuberculosis: CT and Pathologic Correlation
Journal of Computer Assisted Tomography
Issue: Volume 24(5), September/October 2000, pp 691-698
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