Pulmonary infection

Question 1

Imaging findings in primary TB

Answer 1

• Patchy consolidation
• Centrilobular/tree-in-bud nodules
• Random nodules (miliary pattern - this can occur both in primary or reactivation TB)
• Adenopathy (necrotic center)
• Pleural effusion

Can occur anywhere, but most commonly in lower or RML

Question 2

Imaging findings of post-primary TB

Answer 2

• Upper lobe cavitation
• Consolidation
• Tree in bud nodules

Plus classical clinical presentation
Usually don’t have adenopathy (unless immunocompromised)

Question 3

Imaging findings in atypical mycobacterial infx

Answer 3

Tree-in-bud nodules, bronchiectasis
RML and lingula
(Lady Windermere)

“Hot tub lung”, features of HP - centrilobular nodules, gg

Question 4

Imaging findings in PJP

Answer 4

Bilateral, perihilar airspace opacities
+/- septal thickening (crazy paving)
+/- upper lobe pneumatoceles

Question 5

List 5 subtypes of aspergillus

Answer 5

*ONLY OCCURS IN PT WITH ABNORMAL LUNGS OR ABNORMAL IMMUNITY
Inc. immune response (asthma or CF) - ABPA - finger in glove

Abnormal lungs (pre-existing cavity from TB or sarcoid) - Aspergilloma/mycetoma - monod sign

Abnormal host (alcoholic, diabetes, debilitated) - Semi-invasive - chronic consolidation, cavitation upper lobes

Immunocompromised - 2 subtypes:

• airway invasive - bronchiolitis to bronchopneumonia
• angioinvasive - halo sign –> air crescent sign (healing process)