https://doi.org/10.4081/monaldi.2022.2415
Comparative analysis of airway invasive aspergillosis and endobronchial spread of tuberculosis on high resolution computed tomography
Accepted: October 18, 2022
PDF: 411
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The presence of tree-in-bud (T-I-B) pulmonary opacities on high resolution computed tomography (HRCT) in tuberculosis endemic areas is frequently regarded as a sine qua non for endobronchial tuberculosis (TB). That is not always the case, however. They can also be found in immunocompromised non-neutropenic patients with airway invasive aspergillosis (IA). Understanding the differences between the two conditions is thus critical for making an accurate diagnosis. This research aims to pinpoint those distinguishing characteristics. The study defines the distribution and morphology of T-I-B opacities and other ancillary pulmonary findings in the two conditions by performing a retrospective analysis of HRCT features in 53 immunocompromised patients with lower respiratory tract symptoms, 38 of whom were positive for TB on BAL fluid analysis and 15 confirmed IA by Galactomannan method. While the global distribution of T-I-B opacities affecting all lobes favoured TB (p=0.002), the basal distribution overwhelmingly favoured IA (p<0.0001). Morphologically, dense nodules with discrete margins were associated with TB, whereas nodules with ground-glass density and fuzzy margins were associated with IA. Clustering of nodules was observed in 18 TB patients (p=0.0008). Cavitation was found in 14 (36.84%) of TB patients but not in any of the IA patients. Peri-bronchial consolidation was found in seven (46.67%) of the IA cases and four (10.53%) of the TB cases (p=0.005, 0.007). The presence of ground-glass opacity and bronchiectasis did not differ significantly between the two groups. Not all T-I-B opacities on HRCT chest in immunocompromised patients in endemic TB areas should be reported as tubercular. Immunocompromised non-neutropenic patients with airway IA can be identified earlier with tree-in-bud opacities on HRCT chest, even in the absence of a nodule with halo, resulting in earlier and more effective management.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Ekta Gupta, Pooja Singh, Sunaina Tejpal Karna, Yogesh Niwariya, Vaishali Waindeskar, Sourabh Jain, Rajesh Panda, Sandeep Kumar, Comparison of lung ultrasound technique versus clinical method to evaluate the accuracy of size and placement of left endobronchial double lumen tube in patients undergoing elective thoracic surgery: a prospective observational study , Monaldi Archives for Chest Disease: Vol. 94 No. 3 (2024)
- Cuneyt Tetikkurt, Nurbanu Inci, Hail Yanardag, Diagnostic utility of PET/CT in a patient with miliary tuberculosis , Monaldi Archives for Chest Disease: Vol. 89 No. 2 (2019)
- Sara Annoni, Angela Bellofiore, Elena Repossini, Marta Lazzeri, Antonello Nicolini, Paolo Tarsia, Effectiveness of chest physiotherapy and pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: a narrative review , Monaldi Archives for Chest Disease: Vol. 90 No. 1 (2020)
- Deepen Sharma, Rakhee Khanduri, Shailendra Raghuvanshi, Smita Chandra, Sushant Khanduri, Varuna Jethani, Manoj Kumar, Clinical, radiological and histopathological profile of patients with endobronchial lesions on fibreoptic bronchoscopy , Monaldi Archives for Chest Disease: Vol. 93 No. 3 (2023)
- Mohammad Samet, Hossein Soleimani Salehabadi, Pulmonary infection with an unusual microorganism , Monaldi Archives for Chest Disease: Early Access
- Shivam Garg, Pratap Upadhya, Arul Kumar, Norton Stephen, Bala Subramanian, Overcoming the challenges of a misdiagnosed rare lung disease – idiopathic pleuroparenchymal fibroelastosis , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- Irineu Gregnanin Pedron, Comments on “Review of the association between periodontitis and chronic obstructive pulmonary disease in smokers†, Monaldi Archives for Chest Disease: Vol. 89 No. 3 (2019)
- Evgenia I. Kalamara, Evangelos T. Ballas, Evangelia S. Panagiotidou, Lambda sign on a gallium scan: not always sarcoidosis , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
- Martina Turrin, Francesca Maria Pontoriero, Giulia Grisostomi, Giordano Fiorentù, Francesca Zampieri, Francesca Savoia, Cosimo Catino, Giuseppe Zanardi, Piera Peditto, Nicola Malacchini, Fabiola Zeraj, Matteo Bonato, Diana Sacchi, Maria Guido, Giovanni Morana, Micaela Romagnoli, Tracheal atypical solitary carcinoid in a so-called “difficult asthma”: a diagnostic challenge , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- Omkar K. Choudhari, Umesh Chandra Ojha, Dipti Gothi, Sonam Spalgais, Pratap Singh, Anita Rani, Diffuse alveolar hemorrhage secondary to plastic fume exposure: A case report , Monaldi Archives for Chest Disease: Vol. 90 No. 3 (2020)
<< < 20 21 22 23 24 25 26 > >>
You may also start an advanced similarity search for this article.
