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Article in Japanese
Miliary tuberculosis: A wide variety of radiological and clinical findings
Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital
Radiological diagnosis in the early stages is very important to improve the poor prognosis of miliary tuberculosis. The characteristic radiographic findings consist of innumerable miliary nodules scattered diffusely throughout both lungs. High-resolution computed tomography (HRCT) is more helpful in the precise assessment of individual lesions. The fundamental finding of HRCT is a random distribution of tiny nodules up to 3 mm in diameter. Other compatible findings include a tendency of larger nodules in the upper lung rather than in the lower, ground-glass opacity and interlobular septal thickening in the lower lung, lymphadenopathy, and pleural effusion. Upper-lung dominant large nodules or formation of multiple cysts are unusual but possible findings. In patients with adult respiratory distress syndrome (ARDS) and pulmonary edema, radiographic diagnosis is difficult because miliary nodules are superimposed on wide-spreading dense infiltrative shadows.
Miliary tuberculosis Hematogenous dissemination High-resolution CT (HRCT) Random distribution Adult respiratory distress syndrome (ARDS)
AJRS, 2(5): 513-520, 2013