Journal List > J Korean Soc Radiol > v.65(6) > 1087050

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Jeong, Seon, Choi, and Kim: An Unusual Radiologic Manifestation of Pulmonary Tuberculosis with Bilateral Multiple Lung Nodules and Diffuse Alveolar Hemorrhage: A Case Report
Chest Radiology
Case Report

Journal of the Korean Society of Radiology 2011; 65(6): 585-588.

Published online: 31 December 2011

DOI: https://doi.org/10.3348/jksr.2011.65.6.585

An Unusual Radiologic Manifestation of Pulmonary Tuberculosis with Bilateral Multiple Lung Nodules and Diffuse Alveolar Hemorrhage: A Case Report

Seo In Jeong, MD2, Hyun Ju Seon, MD1, Song Choi, MD2, Yun Hyeon Kim, MD1

1Department of Radiology, Chonnam National University Hospital, Gwangju, Korea.

2Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea.

Corresponding author: Hyun Ju Seon, MD. Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 501-757, Korea. Tel. 82-62-220-5746, Fax. 82-62-226-4380, sunaura@hanmail.net

Received 7 June 2011       Accepted 24 August 2011

Copyright © 2011 The Korean Society of Radiology

Abstract

Pulmonary tuberculosis presenting as bilateral multiple lung nodules or diffuse alveolar hemorrhage is very rare. Here, we report a case of pulmonary tuberculosis presenting as bilateral multiple lung nodules and diffuse alveolar hemorrhage mimicking granulomatous vasculitis, such as Wegener's granulomatosis.

Keywords: Pulmonary Tuberculosis, Multiple Pulmonary Nodules, Diffuse Alveolar Hemorrhage

Figures and Tables

Fig. 1

A 70-year-old man with pulmonary tuberculosis.

A. Initial chest PA radiogram shows multiple nodular opacities with mildly and diffusely increased opacity in both lungs and consolidation in right lower lung.
B, C. Initial chest CT scan shows multiple bilateral nodules with ground glass attenuation halo (white arrows in B, C) mixed with crazy-paving pattern lesions (arrowheads in C) in both lung fields with more prominent involvement in the both lower lobes. Focal area of fibrotic old inflammatory lesion suggesting inactive pulmonary tuberculosis is also shown in posterior segment of right upper lobe (black arrows in B).
D. Follow up chest PA radiogram after anti-tuberculosis medication shows improvement of multiple nodular opacities in both lungs and consolidation in right lower lung.
E, F. Follow up chest CT after anti-tuberculosis medication shows complete improvement of multiple bilateral nodules and crazy-paving pattern lesions in both lungs with remained focal area of fibrotic old inflammatory lesion in posterior segment of RUL (black arrows in E). Note.-PA = posteroanterior
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