DISKUSI TOPIK

TUBERCULOSIS
INAYAH
I11111027
KEPANITERAAN KLINIK RADIOLOGI RS UNTAN
PERIODE 28 MARET 2016 24 APRIL 2016

DEFINISI

Tuberculosis is a chronic infection caused by

Mycobacterium tuberculosis , affecting mainly
the respiratory tract, though it can involve any
system in the body.
The immigrant population, debilitated or
immunosuppressed patients are all prone to the
infection.

GENERAL INDICATIONS FOR

A CHEST X-RAY TO DETECT
TB

UNEXPLAINED
symptoms

Pulmonary

and/or

Systemic

cough (> 3 weeks)

cough with fever (> 3 days)
pleuritic chest pain, hemoptysis, dyspnea (promptly)
fever, night sweats, weight loss

Routine Screen in persons found to have a

positive tuberculin skin test
Routine screen in persons found to have HIV
Infection
Routine Screen in select high risk populations

PRIMARY TUBERCULOSIS

Primary tuberculosis is seen in patients not

previously exposed to M tuberculosis
most common in infants and children and has
the highest prevalence in children under 5
years of age.
At radiology, primary tuberculosis manifests
as four main entities:

parenchymal disease
Lymphadenopathy
miliary disease
pleural effusion.

PARENCHYMAL DISEASE

Manifests as dense, homogeneous

parenchymal consolidation in any
lobe.

LYMPHADENOPATHY

Lymphadenopathy is typically
unilateral and right sided,
involving the hilum and right
paratracheal region.

RANKE COMPLEX

The combination of
calcified hilar nodes
and a Ghon focus is
called a Ranke
complex

KOMPLEKS PRIMER

KOMPLEKS PRIMER

MILIARY DISEASE
It is usually seen in the elderly,
infants,
and
immunocompromised persons,
manifesting within 6 months of
initial exposure.
The
classic
radiographic
findings of evenly distributed
diffuse small 23-mm nodules.

Miliary tuberculosis in a patient with

acquired immunodeficiency syndrome.
Note the fie diffuse nodular pattern
throughout both lungs

MILIARY DISEASE

PRIMARY TUBERCULOSIS

Immunocompromised or chronically ill patients

with primary TB usually have radiographic
abnormalities.
This
includes
nonspecific
consolidation, cavitary nodules and masses,
small miliary nodules, necrotizing adenopathy,
and pleural effusions.
In fact, in a patient with known TB, a cavitary
nodule or mass with an airfluid level is
considered
diagnostic
for
transmissible
disease and the patient should be immediately
isolated in a negative pressure environment.

PRIMARY TUBERCULOSIS

Tuberculosis is left upper

lobe

Frontal radiograph shows

consolidation and cavitary
disease (black arrow)

POSTPRIMARY
TUBERCULOSIS

Occurs in patients previously sensitized to M

tuberculosis. The term postprimary tuberculosis
is generally used to refer to both reinfection with
and reactivation of tuberculosis.
At radiology, postprimary tuberculosis may
manifest as:
parenchymal disease
airway involvement
pleural extension.

KLASIFIKASI TUBERKULOSIS SKUNDER

(American Tuberculosis Association)

Minimal tuberculosis
Luas sarang yang terlihat tidak
melebihi daerah yang dibatasi oleh
garis median, apeks, dan iga 2
depan
Tidak ada cavitas
Moderately advanced tuberculosis
Luas sarangyang bersifat bercak
tidak melebihi luas satu paru
Kavitas tidak melebihi diameter 4
cm
Jika ada daerah konsolidasi luasya
tidak melebihi luas satu lobus
Far advanced tuberculosis
jika
ada
kavitas
diameter
keseluruhan semua lubang melebihi
4 cm

Minimal Tuberculosis

Moderately advanced tuberculosis

Parenchymal disease

The earliest finding in

parenchymal disease is
patchy, poorly defined
consolidation, particularly
in
the
apical
and
posterior segments of the
upper lobes.

FASE TENANG

THANK YOU