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Radiological features of tuberculosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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In primary tuberculosis:

  • less than half of patients show radiological abnormalities
  • there may be hilar lymph node enlargement; this subsides as immunity to the tubercle bacillus develops
  • the hilar nodes or the Ghon focus may be calcified

In post-primary tuberculosis the radiological appearance is variable, including features such as:

  • patchy solid lesions
  • cavitated solid lesions
  • streaky fibrosis
  • flecks of calcification
  • solitary tuberculoma presenting as a coin lesion
  • hilar node enlargement

Classically, in miliary tuberculosis there are millet-sized nodules present throughout the lung fields, in practice, the chest radiograph is often normal.

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