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Erschienen in: Pediatric Radiology 8/2012

01.08.2012 | Original Article

CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities

verfasst von: Susan Lucas, Savvas Andronikou, Pierre Goussard, Robert Gie

Erschienen in: Pediatric Radiology | Ausgabe 8/2012

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Abstract

Background

Lymphobronchial tuberculosis (TB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children.

Objective

To describe CT findings of lymphobronchial TB in children, the parenchymal complications and associated abnormalities.

Materials and methods

CT scans of children with lymphobronchial TB were reviewed retrospectively. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented.

Results

Infants comprised 51% of patients. The commonest site of lymphadenopathy was the subcarinal mediastinum (97% of patients). Bronchial compression was seen in all children (259 bronchi, of these 28% the bronchus intermedius) with severe or complete stenosis in 23% of affected bronchi. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly on the right side (63%). Associated abnormalities included ovoid lesions, miliary nodules, pleural disease and intracavitary bodies.

Conclusion

Airway compression was more severe in infants and most commonly involved the bronchus intermedius. Numerous parenchymal complications were documented, all showing right-side predominance.
Literatur
2.
Zurück zum Zitat Marais BJ, Gie RP, Schaaf HS et al (2004) The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 8:392–402PubMed Marais BJ, Gie RP, Schaaf HS et al (2004) The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 8:392–402PubMed
3.
Zurück zum Zitat Beyers JA (1979) The radiological features of primary pulmonary tuberculosis. S Afr Med J 55:994–997PubMed Beyers JA (1979) The radiological features of primary pulmonary tuberculosis. S Afr Med J 55:994–997PubMed
4.
Zurück zum Zitat Daltro PA, Nunez-Santos E (2008) Pediatric tuberculosis. In: Lucaya J, Strife JL (eds) Pediatric chest imaging: chest imaging in infants and children. Springer, Berlin, pp 165–181 Daltro PA, Nunez-Santos E (2008) Pediatric tuberculosis. In: Lucaya J, Strife JL (eds) Pediatric chest imaging: chest imaging in infants and children. Springer, Berlin, pp 165–181
5.
Zurück zum Zitat Marais BJ, Gie RP, Schaaf HS et al (2004) A proposed radiological classification of childhood intra-thoracic tuberculosis. Pediatr Radiol 34:886–894PubMedCrossRef Marais BJ, Gie RP, Schaaf HS et al (2004) A proposed radiological classification of childhood intra-thoracic tuberculosis. Pediatr Radiol 34:886–894PubMedCrossRef
6.
Zurück zum Zitat Goussard P, Gie R (2007) Airway involvement in pulmonary tuberculosis. Paediatr Respir Rev 8:118–123PubMedCrossRef Goussard P, Gie R (2007) Airway involvement in pulmonary tuberculosis. Paediatr Respir Rev 8:118–123PubMedCrossRef
7.
Zurück zum Zitat Gie RP, Goussard P, Kling S et al (2004) Unusual forms of intrathoracic tuberculosis in children and their management. Paediatr Respir Rev 5 Suppl A:S139–S141 Gie RP, Goussard P, Kling S et al (2004) Unusual forms of intrathoracic tuberculosis in children and their management. Paediatr Respir Rev 5 Suppl A:S139–S141
8.
Zurück zum Zitat Andronikou S, Vanhoenacker FM, De Backer AI (2009) Advances in imaging chest tuberculosis: blurring of differences between children and adults. Clin Chest Med 30:717–744PubMedCrossRef Andronikou S, Vanhoenacker FM, De Backer AI (2009) Advances in imaging chest tuberculosis: blurring of differences between children and adults. Clin Chest Med 30:717–744PubMedCrossRef
9.
Zurück zum Zitat Venta LA, Shapir J (1985) Enhancement of pulmonary vasculature in pulmonary consolidation as seen by computed tomography. J Comput Tomogr 9:133–135PubMedCrossRef Venta LA, Shapir J (1985) Enhancement of pulmonary vasculature in pulmonary consolidation as seen by computed tomography. J Comput Tomogr 9:133–135PubMedCrossRef
10.
Zurück zum Zitat Andronikou S, Wieslthaler N (2009) Imaging for tuberculosis in children. In: Schaaf HS, Zumla A (eds) Tuberculosis: a comprehensive clinical reference. Saunders Elsevier, Philadelphia, pp 261–295 Andronikou S, Wieslthaler N (2009) Imaging for tuberculosis in children. In: Schaaf HS, Zumla A (eds) Tuberculosis: a comprehensive clinical reference. Saunders Elsevier, Philadelphia, pp 261–295
11.
Zurück zum Zitat Griffith-Richards SB, Goussard P, Andronikou S et al (2007) Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis. Pediatr Radiol 37:798–804PubMedCrossRef Griffith-Richards SB, Goussard P, Andronikou S et al (2007) Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis. Pediatr Radiol 37:798–804PubMedCrossRef
12.
Zurück zum Zitat Papagiannopoulos KA, Linegar AG, Harris DG et al (1999) Surgical management of airway obstruction in primary tuberculosis in children. Ann Thorac Surg 68:1182–1186PubMedCrossRef Papagiannopoulos KA, Linegar AG, Harris DG et al (1999) Surgical management of airway obstruction in primary tuberculosis in children. Ann Thorac Surg 68:1182–1186PubMedCrossRef
13.
Zurück zum Zitat Hewitson JP, Von Oppell UO (1997) Role of thoracic surgery for childhood tuberculosis. World J Surg 21:468–474PubMedCrossRef Hewitson JP, Von Oppell UO (1997) Role of thoracic surgery for childhood tuberculosis. World J Surg 21:468–474PubMedCrossRef
14.
Zurück zum Zitat Freixinet J, Varela A, Lopez RL et al (1995) Surgical treatment of childhood mediastinal tuberculous lymphadenitis. Ann Thorac Surg 59:644–646PubMedCrossRef Freixinet J, Varela A, Lopez RL et al (1995) Surgical treatment of childhood mediastinal tuberculous lymphadenitis. Ann Thorac Surg 59:644–646PubMedCrossRef
15.
Zurück zum Zitat Hammer GB, Fitzmaurice BG, Brodsky JB (1999) Methods for single-lung ventilation in pediatric patients. Anesth Analg 89:1426–1429PubMed Hammer GB, Fitzmaurice BG, Brodsky JB (1999) Methods for single-lung ventilation in pediatric patients. Anesth Analg 89:1426–1429PubMed
16.
Zurück zum Zitat Respiration and circulation (biological handbooks) (1971) Federation of American Societies for Experimental Biology. Bethesda, MD, pp 105–108 Respiration and circulation (biological handbooks) (1971) Federation of American Societies for Experimental Biology. Bethesda, MD, pp 105–108
17.
Zurück zum Zitat Weibel ER (1963) Morphometry of the human lung. Springer, Berlin Weibel ER (1963) Morphometry of the human lung. Springer, Berlin
18.
Zurück zum Zitat The lung: scientific foundations (1997) (2nd edn) Lippincott-Raven, Philadelphia, pp 1064–1066 The lung: scientific foundations (1997) (2nd edn) Lippincott-Raven, Philadelphia, pp 1064–1066
19.
Zurück zum Zitat Middelkoop K, Bekker LG, Morrow C et al (2009) Childhood tuberculosis infection and disease: a spatial and temporal transmission analysis in a South African township. S Afr Med J 99:738–743PubMed Middelkoop K, Bekker LG, Morrow C et al (2009) Childhood tuberculosis infection and disease: a spatial and temporal transmission analysis in a South African township. S Afr Med J 99:738–743PubMed
20.
Zurück zum Zitat Parisi MT, Jensen MC, Wood BP (1994) Pictorial review of the usual and unusual roentgen manifestations of childhood tuberculosis. Clin Imaging 18:149–154PubMedCrossRef Parisi MT, Jensen MC, Wood BP (1994) Pictorial review of the usual and unusual roentgen manifestations of childhood tuberculosis. Clin Imaging 18:149–154PubMedCrossRef
21.
Zurück zum Zitat Andronikou S, Joseph E, Lucas S et al (2004) CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children. Pediatr Radiol 34:232–236PubMedCrossRef Andronikou S, Joseph E, Lucas S et al (2004) CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children. Pediatr Radiol 34:232–236PubMedCrossRef
22.
Zurück zum Zitat de Charnace G, Delacourt C (2001) Diagnostic techniques in paediatric tuberculosis. Paediatr Respir Rev 2:120–126PubMedCrossRef de Charnace G, Delacourt C (2001) Diagnostic techniques in paediatric tuberculosis. Paediatr Respir Rev 2:120–126PubMedCrossRef
23.
Zurück zum Zitat Delacourt C, Mani TM, Bonnerot V et al (1993) Computed tomography with normal chest radiograph in tuberculous infection. Arch Dis Child 69:430–432PubMedCrossRef Delacourt C, Mani TM, Bonnerot V et al (1993) Computed tomography with normal chest radiograph in tuberculous infection. Arch Dis Child 69:430–432PubMedCrossRef
24.
Zurück zum Zitat Venkateswaran RV, Barron DJ, Brawn WJ et al (2005) A forgotten old disease: mediastinal tuberculous lymphadenitis in children. Eur J Cardiothorac Surg 27:401–404PubMedCrossRef Venkateswaran RV, Barron DJ, Brawn WJ et al (2005) A forgotten old disease: mediastinal tuberculous lymphadenitis in children. Eur J Cardiothorac Surg 27:401–404PubMedCrossRef
25.
Zurück zum Zitat Andreu J, Caceres J, Pallisa E et al (2004) Radiological manifestations of pulmonary tuberculosis. Eur J Radiol 51:139–149PubMedCrossRef Andreu J, Caceres J, Pallisa E et al (2004) Radiological manifestations of pulmonary tuberculosis. Eur J Radiol 51:139–149PubMedCrossRef
26.
Zurück zum Zitat Mukund A, Khurana R, Bhalla AS et al (2011) CT patterns of nodal disease in pediatric chest tuberculosis. World J Radiol 3:17–23PubMedCrossRef Mukund A, Khurana R, Bhalla AS et al (2011) CT patterns of nodal disease in pediatric chest tuberculosis. World J Radiol 3:17–23PubMedCrossRef
27.
Zurück zum Zitat Newton SM, Brent AJ, Anderson S et al (2008) Paediatric tuberculosis. Lancet Infect Dis 8:498–510PubMedCrossRef Newton SM, Brent AJ, Anderson S et al (2008) Paediatric tuberculosis. Lancet Infect Dis 8:498–510PubMedCrossRef
28.
Zurück zum Zitat Palme IB, Gudetta B, Bruchfeld J et al (2002) Impact of human immunodeficiency virus 1 infection on clinical presentation, treatment outcome and survival in a cohort of Ethiopian children with tuberculosis. Pediatr Infect Dis J 21:1053–1061PubMedCrossRef Palme IB, Gudetta B, Bruchfeld J et al (2002) Impact of human immunodeficiency virus 1 infection on clinical presentation, treatment outcome and survival in a cohort of Ethiopian children with tuberculosis. Pediatr Infect Dis J 21:1053–1061PubMedCrossRef
29.
Zurück zum Zitat Chintu C, Mudenda V, Lucas S et al (2002) Lung diseases at necropsy in African children dying from respiratory illnesses: a descriptive necropsy study. Lancet 360:985–990PubMedCrossRef Chintu C, Mudenda V, Lucas S et al (2002) Lung diseases at necropsy in African children dying from respiratory illnesses: a descriptive necropsy study. Lancet 360:985–990PubMedCrossRef
30.
Zurück zum Zitat Schaaf HS, Marais BJ, Whitelaw A et al (2007) Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases. BMC Infect Dis 7:140PubMedCrossRef Schaaf HS, Marais BJ, Whitelaw A et al (2007) Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases. BMC Infect Dis 7:140PubMedCrossRef
31.
Zurück zum Zitat Hesseling AC, Cotton MF, Jennings T et al (2009) High incidence of tuberculosis among HIV-infected infants: evidence from a South African population-based study highlights the need for improved tuberculosis control strategies. Clin Infect Dis 48:108–114PubMedCrossRef Hesseling AC, Cotton MF, Jennings T et al (2009) High incidence of tuberculosis among HIV-infected infants: evidence from a South African population-based study highlights the need for improved tuberculosis control strategies. Clin Infect Dis 48:108–114PubMedCrossRef
32.
Zurück zum Zitat Leung AN, Muller NL, Pineda PR et al (1992) Primary tuberculosis in childhood: radiographic manifestations. Radiology 182:87–91PubMed Leung AN, Muller NL, Pineda PR et al (1992) Primary tuberculosis in childhood: radiographic manifestations. Radiology 182:87–91PubMed
33.
Zurück zum Zitat Papaioannou G, Young C, Owens CM (2007) Multidetector row CT for imaging the paediatric tracheobronchial tree. Pediatr Radiol 37:515–529PubMedCrossRef Papaioannou G, Young C, Owens CM (2007) Multidetector row CT for imaging the paediatric tracheobronchial tree. Pediatr Radiol 37:515–529PubMedCrossRef
34.
Zurück zum Zitat Maydell A, Goussard P, Andronikou S et al (2010) Radiological changes post-lymph node enucleation for airway obstruction in children with pulmonary tuberculosis. Eur J Cardiothorac Surg 38:478–483 Maydell A, Goussard P, Andronikou S et al (2010) Radiological changes post-lymph node enucleation for airway obstruction in children with pulmonary tuberculosis. Eur J Cardiothorac Surg 38:478–483
35.
Zurück zum Zitat Lawler LP, Corl FM, Haponik EF et al (2002) Multidetector row computed tomography and 3-dimensional volume rendering for adult airway imaging. Curr Probl Diagn Radiol 31:115–133PubMedCrossRef Lawler LP, Corl FM, Haponik EF et al (2002) Multidetector row computed tomography and 3-dimensional volume rendering for adult airway imaging. Curr Probl Diagn Radiol 31:115–133PubMedCrossRef
Metadaten
Titel
CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities
verfasst von
Susan Lucas
Savvas Andronikou
Pierre Goussard
Robert Gie
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 8/2012
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-012-2399-x

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