Clinical Characteristics and Radiologic Patterns of Adelescents with Pulmonary Tuberculosis: Relevance to the Reactive Tuberculosis

Seok Jin Kang; Yeo Hyang Kim; Chi Young Jung; Hee Jung Lee; Myung Chul Hyun

doi:10.7581/pard.2012.22.2.163

Journal List > Pediatr Allergy Respir Dis > v.22(2) > 1033169

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Kang, Kim, Jung, Lee, and Hyun: Clinical Characteristics and Radiologic Patterns of Adelescents with Pulmonary Tuberculosis: Relevance to the Reactive Tuberculosis

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(2): 163-170.

Published online: 30 June 2012

DOI: https://doi.org/10.7581/pard.2012.22.2.163

Clinical Characteristics and Radiologic Patterns of Adelescents with Pulmonary Tuberculosis: Relevance to the Reactive Tuberculosis

Seok Jin Kang, MD¹, Yeo Hyang Kim, MD, PhD¹, Chi Young Jung, MD, PhD², Hee Jung Lee, MD, PhD³, Myung Chul Hyun, MD, PhD⁴

¹Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea.

²Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.

³Department of Radiology, Keimyung University School of Medicine, Daegu, Korea.

⁴Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.

Corresponding author (kimyhped@hanmail.net)

Received 16 January 2012 Revised 14 February 2012 Accepted 9 March 2012

Abstract

Purpose

To evaluate the clinical characteristics and radiologic patterns of adolescents with pulmonary tuberculosis (TB), and to assess whether they are related with primary TB or reactive TB.

Methods

Among the enrolled patients who were diagnosed with pulmonary TB from March 2000 to May 2011, 36 with plain radiography and/or chest computed tomography (CT) were reviewed. We reviewed retrospectively their medical charts to collect clinical data and past history. Among these 36 patients, plain radiography of the 36 patients and chest CT of the 34 patients were retrospectively evaluated.

Results

The patients consisted of 18 males and 18 females, and their median age was 14 years old. The most common clinical presentation was cough and fever. Half of them had chronic cough for more than two weeks. Ten patients had history of close contact with adult patients with active pulmonary TB: 7 patients with their parents, 2 patients with friends, 1 patient with their grandmother. The most frequent pattern of plain radiography was pleural effusion (16/36). In the chest CT findings, all cases showed parenchymal lesions and lymphadenopathy. In addition, 91% of the cases showed acinar nodules. The pattern of pleural effusion revealed associated ipsilateral pleural lymph node and subpleural nodule. Rim enhancement and calcification of the lymph node demonstrated 9% (3/34) and 12% (4/34), respectively. Only two of them showed typical hilar lymphadenopathy in chest X ray and CT.

Conclusion

The radiologic findings of adolescents with pulmonary TB show patterns for rather reactive than primary TB. For diagnosis of adolescent pulmonary TB, chest CT is more helpful than that of plain radiography.

Keywords: Adolescent, Computed tomography, Tuberculosis, pulmonary

Figures and Tables

Fig. 1

Location of pulmonary parenchymal lesions in plain radiography.

Fig. 2

Location of pulmonary parenchymal lesions in chest computed tomography scan.

Fig. 3

Location of lymph node involved area in the chest computed tomography scan. 1, highest mediastinal nodes; 2, pre-vascular and retrotracheal nodes; 3, right upper paratracheal nodes; 4 and 5, right and left lower paratracheal nodes; 6, subaortic nodes; 7, right hilar nodes; 8, subcarinal nodes; 9, paraoesophageal nodes; 10, pulmonary ligament nodes.

Table 1

Demographic and Clinical Characteristics of the Adolescents with Pulmonary Tuberculosis (TB)

Table 2

Abnormal Findings in Chest Computed Tomography in 10 Patients with Normal Chest X-ray

RUL, right upper lobe; RML, right middle lobe; RLL, right lower lobe; LUL, left upper lobe; LLL, left lower lobe.

Table 3

The Characteristics of Pulmonary Parenchyaml Lesions Using Chest Computed Tomography in Adolescents with Pulmonary Tuberculosis

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