J M Ko1, H J Park1, D G Cho2, C H Kim3. 1. Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2. Department of Thoracic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 3. Department of Respiratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Abstract
OBJECTIVE: To determine whether pulmonary changes on computed tomography (CT) are helpful in differentiating between pleural tuberculosis (TB) and non-tuberculous pleural infection MATERIALS AND METHODS: We retrospectively reviewed CT scans of patients with pleural tuberculous and non-tuberculous empyema, focusing on pulmonary changes such as consolidation, ground glass opacity, interlobular septal thickening, cavitation, abscess and presence and distribution of micronodules. We also assessed the presence of loss of overlying pleural integrity, peripheral bronchopleural fistula and lymphadenopathy. RESULTS: We evaluated 65 patients with pleural TB and 43 with empyema. CT findings of pleural TB differed significantly from those of empyema with interlobular septal thickening (P = 0.022) and micronodules with subpleural, peribronchovascular and septal distribution (P < 0.001). Subpleural abscess was more frequently seen in empyema, accompanying loss of overlying pleural integrity and peripheral bronchopleural fistula (P < 0.001), but there was no statistical difference between the two groups in prevalence of consolidation, ground glass opacity, cavitation, centrilobular nodules or lymphadenopathy. CONCLUSION: Interlobular septal thickening and micronodules with perilymphatic distribution are characteristic CT findings of pleural TB but not empyema. Presence of subpleural abscess and loss of pleural integrity or peripheral bronchopleural fistula are highly suggestive of empyema.
OBJECTIVE: To determine whether pulmonary changes on computed tomography (CT) are helpful in differentiating between pleural tuberculosis (TB) and non-tuberculous pleural infection MATERIALS AND METHODS: We retrospectively reviewed CT scans of patients with pleural tuberculous and non-tuberculous empyema, focusing on pulmonary changes such as consolidation, ground glass opacity, interlobular septal thickening, cavitation, abscess and presence and distribution of micronodules. We also assessed the presence of loss of overlying pleural integrity, peripheral bronchopleural fistula and lymphadenopathy. RESULTS: We evaluated 65 patients with pleural TB and 43 with empyema. CT findings of pleural TB differed significantly from those of empyema with interlobular septal thickening (P = 0.022) and micronodules with subpleural, peribronchovascular and septal distribution (P < 0.001). Subpleural abscess was more frequently seen in empyema, accompanying loss of overlying pleural integrity and peripheral bronchopleural fistula (P < 0.001), but there was no statistical difference between the two groups in prevalence of consolidation, ground glass opacity, cavitation, centrilobular nodules or lymphadenopathy. CONCLUSION: Interlobular septal thickening and micronodules with perilymphatic distribution are characteristic CT findings of pleural TB but not empyema. Presence of subpleural abscess and loss of pleural integrity or peripheral bronchopleural fistula are highly suggestive of empyema.
Authors: David W Denning; Iain D Page; Jeremiah Chakaya; Kauser Jabeen; Cecilia M Jude; Muriel Cornet; Ana Alastruey-Izquierdo; Felix Bongomin; Paul Bowyer; Arunaloke Chakrabarti; Sara Gago; John Guto; Bruno Hochhegger; Martin Hoenigl; Muhammad Irfan; Nicholas Irurhe; Koichi Izumikawa; Bruce Kirenga; Veronica Manduku; Samihah Moazam; Rita O Oladele; Malcolm D Richardson; Juan Luis Rodriguez Tudela; Anna Rozaliyani; Helmut J F Salzer; Richard Sawyer; Nasilele F Simukulwa; Alena Skrahina; Charlotte Sriruttan; Findra Setianingrum; Bayu A P Wilopo; Donald C Cole; Haileyesus Getahun Journal: Emerg Infect Dis Date: 2018-08 Impact factor: 6.883