Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. WHO (2010) Global tuberculosis control: a short update to the 2009 report. http://www.who.int/tb/publications/global_report/2009/update/en/index.html Accessed on 22/3/2010

  2. 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 8:392–402

    PubMed  CAS  Google Scholar 

  3. Beyers JA (1979) The radiological features of primary pulmonary tuberculosis. S Afr Med J 55:994–997

    PubMed  CAS  Google Scholar 

  4. 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

    Google Scholar 

  5. Marais BJ, Gie RP, Schaaf HS et al (2004) A proposed radiological classification of childhood intra-thoracic tuberculosis. Pediatr Radiol 34:886–894

    Article  PubMed  Google Scholar 

  6. Goussard P, Gie R (2007) Airway involvement in pulmonary tuberculosis. Paediatr Respir Rev 8:118–123

    Article  PubMed  Google Scholar 

  7. 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. Andronikou S, Vanhoenacker FM, De Backer AI (2009) Advances in imaging chest tuberculosis: blurring of differences between children and adults. Clin Chest Med 30:717–744

    Article  PubMed  Google Scholar 

  9. Venta LA, Shapir J (1985) Enhancement of pulmonary vasculature in pulmonary consolidation as seen by computed tomography. J Comput Tomogr 9:133–135

    Article  PubMed  CAS  Google Scholar 

  10. 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

    Google Scholar 

  11. Griffith-Richards SB, Goussard P, Andronikou S et al (2007) Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis. Pediatr Radiol 37:798–804

    Article  PubMed  Google Scholar 

  12. Papagiannopoulos KA, Linegar AG, Harris DG et al (1999) Surgical management of airway obstruction in primary tuberculosis in children. Ann Thorac Surg 68:1182–1186

    Article  PubMed  CAS  Google Scholar 

  13. Hewitson JP, Von Oppell UO (1997) Role of thoracic surgery for childhood tuberculosis. World J Surg 21:468–474

    Article  PubMed  CAS  Google Scholar 

  14. Freixinet J, Varela A, Lopez RL et al (1995) Surgical treatment of childhood mediastinal tuberculous lymphadenitis. Ann Thorac Surg 59:644–646

    Article  PubMed  CAS  Google Scholar 

  15. Hammer GB, Fitzmaurice BG, Brodsky JB (1999) Methods for single-lung ventilation in pediatric patients. Anesth Analg 89:1426–1429

    PubMed  CAS  Google Scholar 

  16. Respiration and circulation (biological handbooks) (1971) Federation of American Societies for Experimental Biology. Bethesda, MD, pp 105–108

  17. Weibel ER (1963) Morphometry of the human lung. Springer, Berlin

  18. The lung: scientific foundations (1997) (2nd edn) Lippincott-Raven, Philadelphia, pp 1064–1066

  19. 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 99:738–743

    PubMed  Google Scholar 

  20. Parisi MT, Jensen MC, Wood BP (1994) Pictorial review of the usual and unusual roentgen manifestations of childhood tuberculosis. Clin Imaging 18:149–154

    Article  PubMed  CAS  Google Scholar 

  21. Andronikou S, Joseph E, Lucas S et al (2004) CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children. Pediatr Radiol 34:232–236

    Article  PubMed  Google Scholar 

  22. de Charnace G, Delacourt C (2001) Diagnostic techniques in paediatric tuberculosis. Paediatr Respir Rev 2:120–126

    Article  PubMed  Google Scholar 

  23. Delacourt C, Mani TM, Bonnerot V et al (1993) Computed tomography with normal chest radiograph in tuberculous infection. Arch Dis Child 69:430–432

    Article  PubMed  CAS  Google Scholar 

  24. Venkateswaran RV, Barron DJ, Brawn WJ et al (2005) A forgotten old disease: mediastinal tuberculous lymphadenitis in children. Eur J Cardiothorac Surg 27:401–404

    Article  PubMed  CAS  Google Scholar 

  25. Andreu J, Caceres J, Pallisa E et al (2004) Radiological manifestations of pulmonary tuberculosis. Eur J Radiol 51:139–149

    Article  PubMed  CAS  Google Scholar 

  26. Mukund A, Khurana R, Bhalla AS et al (2011) CT patterns of nodal disease in pediatric chest tuberculosis. World J Radiol 3:17–23

    Article  PubMed  Google Scholar 

  27. Newton SM, Brent AJ, Anderson S et al (2008) Paediatric tuberculosis. Lancet Infect Dis 8:498–510

    Article  PubMed  Google Scholar 

  28. 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 21:1053–1061

    Article  PubMed  Google Scholar 

  29. 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 360:985–990

    Article  PubMed  Google Scholar 

  30. 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 7:140

    Article  PubMed  Google Scholar 

  31. 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 48:108–114

    Article  PubMed  CAS  Google Scholar 

  32. Leung AN, Muller NL, Pineda PR et al (1992) Primary tuberculosis in childhood: radiographic manifestations. Radiology 182:87–91

    PubMed  CAS  Google Scholar 

  33. Papaioannou G, Young C, Owens CM (2007) Multidetector row CT for imaging the paediatric tracheobronchial tree. Pediatr Radiol 37:515–529

    Article  PubMed  Google Scholar 

  34. 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

    Google Scholar 

  35. 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 31:115–133

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2001, South Africa

    Susan Lucas & Savvas Andronikou

  2. Department Paediatrics, Stellenbosch University, Stellenbosch, South Africa

    Pierre Goussard & Robert Gie

Authors
  1. Susan Lucas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Savvas Andronikou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pierre Goussard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert Gie
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susan Lucas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lucas, S., Andronikou, S., Goussard, P. et al. CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities. Pediatr Radiol 42, 923–931 (2012). https://doi.org/10.1007/s00247-012-2399-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-012-2399-x

Keywords

Search

Navigation