extrapulmonale Manifestationen der Tuberkulose
Extrapulmonary
tuberculosıs: an old but resurgent problem. Axial contrast-enhanced CT (a) and axial T2 weighted MR (b) images of a 66-year-old female demonstrate multiple foci (arrowheads) in the spleen. Note small hypodense areas with peripheral enhancement in foci (a). Splenic TB
Extrapulmonary
tuberculosıs: an old but resurgent problem. Axial FLAIR (a), pre-contrast (b) axial T1 weighted, and post-contrast (c) axial T1 weighted MR images of a 21-year-old male. Axial FLAIR image shows high signal intensity caused by edema and inflammation in the left frontal lobe (star). In both anterior frontal regions (red arrows) and right parietal area (blue arrows) are seen subdural abscesses. In addition, MR images demonstrate meningeal enhancement and thickening (arrowheads)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Ultrasound images from four different female patients (a–d). Abscesses (arrowheads), sinus tracts (arrows), and hypoechoic parenchymal edema areas (stars)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 68-year-old-male. Sagittal reformatted contrast-enhanced CT image reveals an increased thickness of the larynx"s posterior wall (arrow). Sternum fracture is also noted in the manubrium
Extrapulmonary
tuberculosıs: an old but resurgent problem. Contrast-enhanced T1 weighted coronal (a) and sagittal T2 weighted (b) MR images of a 39-year-old female demonstrate multiple lymphadenopathies in the bilateral cervical chains. The patient was diagnosed with tuberculous lymphadenitis
Extrapulmonary
tuberculosıs: an old but resurgent problem. Contrast-enhanced T1 weighted coronal (a) and axial T1 weighted (b) MR images of a 44-year-old female demonstrate multiple lymphadenopathies in the bilateral cervical chains and right supraclavicular region. Multiple intraabdominal lymphadenopathies are also noted (not shown)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 32-year-old male. Painless, discrete, freely mobile, fistulized lumps in the neck are grown progressively (a). Ultrasound showed multiple necrotic lymph nodes (b). Scrofula of the neck
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 50-year-old female. Coronal pre-contrast (a) and post-contrast (b) T1 weighted images reveal enlarged palatine tonsils, which show peripheral enhancement (stars)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 19-year-old male patient. T2 weighted coronal (a), axial FLAIR (b), and T1 weighted post-contrast axial (c) images show periorbital involvement (arrowheads)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 28-year-old female patient. T1 weighted post-contrast image (a) and T2 weighted image (b) with a tuberculous abscess in the left lacrimal sac (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Contrast-enhanced thorax CT image of a 70-year-old female. Multiple mediastinal lymphadenopathies are noted in the prevascular region (red arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Radiologic images of a 38-year-old-female who has a diagnosis of miliary TB. Multiple tuberculomas (red arrows) show peripheral rim-like enhancement on post-contrast T1 weighted image in the cerebellum (a). On T2-weighted images (b, c) demonstrate focal lesions (tuberculomas) with central isointense signal and peripheral hyperintensity in gray matter (blue arrows). Multiple nodules secondary to miliary TB are seen (d)
Extrapulmonary
tuberculosıs: an old but resurgent problem. The chest X-ray (a) and coronal reformatted CT (b) image without contrast of a 4-year-old girl demonstrate unilateral pleural effusion in the right side (stars). Tuberculous pleurisy
Extrapulmonary
tuberculosıs: an old but resurgent problem. Transverse (a) and coronal reformatted (b) CT images without contrast of a 24-year-old female. A mass-like focal pleural lesion in the right side containing a few coarse calcifications is noted. The patient is diagnosed with TB on histopathologic assessment after surgical removal of the mass
Extrapulmonary
tuberculosıs: an old but resurgent problem. Transverse (a) and sagittal reformatted (b) CT images without intravenous contrast of a 55-year-old male. Pericardial thickening with linear calcification (arrowheads), right-sided pleural effusion (black asterisk), and infected fluid collection (white asterisk) in the left pleural cavity are seen. Mediastinal and pericardial tuberculous
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of a 41-year-old female. Axial T2 weighted (a, d), pre-contrast axial T1 weighted (b, e), and post-contrast axial T1 weighted (c, f) images reveal diffuse increased signal intensity, cystic lesions (arrowheads), ductal ectasia (arrow), and thickened skin (curved arrow) in the right breast. Diffuse-type breast TB
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of a 56-year-old male with the diagnosis of tuberculous myelitis. Sagittal T2 weighted image (a) shows a heterogeneous increased signal on the spinal cord (arrow). Pre-contrast (b) and post-contrast (c) T1 weighted images reveal linear contrast enhancement of the same region (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Breast MR images of a 39-year-old female. T2 weighted image (a), T1 weighted image (b) post-contrast (c), and subtracted image (d) demonstrate thickening of the skin (arrowhead) and multiple abscesses (arrows) with peripheral enhancement in the right breast
Extrapulmonary
tuberculosıs: an old but resurgent problem. Transverse abdomen CT image (a) of a 17-year-old female with known TB. Coarse calcifications in the liver parenchyma suggestive of TB sequela are noted. Coronal reformatted CT image of the same patient (b) reveals multiple lymphadenopathies with peripheral calcifications
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 19-year-old male. Post-contrast CT image shows multiple mesenteric lymphadenopathies with peripheral enhancement
Extrapulmonary
tuberculosıs: an old but resurgent problem. Transverse CT image with intravenous contrast of a 29-year-old male. Massive ascites is indicated in the abdomen cavity (stars). The peritoneum"s thin linear contrast enhancement is also noted. Tuberculous peritonitis
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 24-year-old male patient. Axial (a) and coronal postcontrast CT (b) images show mesenteric striation (arrowheads) and ascites (star)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 33-year-old female. Axial post-contrast CT images (a, b) demonstrate omental nodularity, mesenteric fat stranding (arrowheads), and ascites (star). Intraabdominal lymphadenopathies are also evident (arrows) in image b
Extrapulmonary
tuberculosıs: an old but resurgent problem. T2 weighted (a) and post-contrast T1 weighted MR images of a 35-year-old male demonstrate abscess formation with peripheral enhancement in the left iliac muscle (b)
Extrapulmonary
tuberculosis • Disseminated tuberculosis - Ganzer Fall bei Radiopaedia
Extrapulmonary
tuberculosis • Disseminated tuberculosis - Ganzer Fall bei Radiopaedia
Extrapulmonary
tuberculosis • Disseminated tuberculosis - Ganzer Fall bei Radiopaedia
Extrapulmonary
tuberculosis • Disseminated tuberculosis - Ganzer Fall bei Radiopaedia
Extrapulmonary
tuberculosis • Tuberculous arthropathy of wrist - Ganzer Fall bei Radiopaedia
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of a 17-year-old female with the diagnosis of cervical tuberculous myelitis. Sagittal T2 weighted image (a) shows a heterogeneous increased signal (edema, inflammation) on the spinal cord (arrowheads) and focus (arrow). The cervical spinal cord is observed as an enlarged diffuse hypointense area on pre-contrast T1-weighted image (b). Post-contrast (c) T1 weighted image reveals diffuse heterogeneous and focal (arrow) contrast enhancement of the same region. The focus is a tuberculoma (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of a 63-year-old female with central nervous system TB. Focal lesions (arrows) with rim-like enhancement are seen (tuberculoma) on contrast-enhanced coronal T1 weighted images (a, c). Perilesional increased signals (asterisk and arrowheads) due to vasogenic edema are noted on axial FLAIR images (b, d)
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of thoracic vertebrae of a 23-year-old female. Sagittal T2-weighted image reveals a heterogeneous signal increase in the spinal cord (red arrows) (a). Precontrast (b) and postcontrast (c) T1 weighted images of the same patient show linear (arrowheads) and nodular (curved arrow) dural enhancement and tuberculous abscess formations in the posterior epidural space
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of lumbar vertebrae of a 47-year-old male with tuberculous spondylodiscitis. Sagittal T2-weighted image (a) shows the heterogeneous low signal in the anterior parts of the L3 and L4 vertebral bodies and L3-4 intervertebral disc, which offers minimal anterior subligamentous extension (arrows). Pre-contrast (a) and post-contrast (b) T1 weighted images reveal diffuse contrast enhancement of both vertebral bodies in keeping with spondylodiscitis (arrowheads)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 40-year-old female. Contrast-enhancement CT scan (a, b) and Doppler ultrasonography (c) demonstrated a large heterogeneous cystic-necrotic mass in the head of the pancreas
Extrapulmonary
tuberculosıs: an old but resurgent problem. Transverse CT image without intravenous contrast of a 24-year-old female. Diffuse-symmetric wall thickening of the ileal segment is noted (arrows). Ileal TB
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 31-year-old female. Contrast-enhanced CT image demonstrates diffuse-symmetric wall thickening and enhancement of the cecum with surrounding inflammatory changes (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 52-year-old female. Contrast-enhancement CT (a), T2 weighted MR (b), and contrast-enhancement T1 weighted MR (c) images demonstrate a heterogeneous lesion with peripheral enhancement (arrows) in the right adrenal gland (adrenal TB). Multiple calcified heterogeneous areas (arrowheads) are also seen in the liver (hepatic TB)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Contrast-enhancement CT scan of a 48-year-old female with renal tuberculous show debris collection within dilated calyces and parenchymal destruction (with cortical thinning)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Axial (a) and coronal (b) non-contrast CT scan of a 74-year-old male with urinary tuberculous reveal debris collection within the dilated right renal pelvis and dilated right ureter with diffuse wall thickening. 3D MIP Coronal T2-weighted MR urogram shows strictures (arrows) of the right ureter
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 47-year-old male. Coronal post-contrast CT scan shows diffuse thickening of the bladder wall (arrow) and dilated left proximal ureter (arrowheads). Urinary TB
Extrapulmonary
tuberculosıs: an old but resurgent problem. Tuberculous prostatitis (abscesses) in a 53-year-old male. T2 weighted axial (a) and sagittal (b) MR images demonstrate focal, hypointense lesions within the prostate gland (arrows). Contrast-enhancement T1 weighted axial (c) and sagittal (b) MR images show heterogeneous lesions with peripheral enhancement (arrows). A rectal tumor (star) is also seen
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 38-year-old male. Scrotal US image (a) and post-contrast coronal T1 weighted MR image (b) reveal diffuse heterogeneity, deformation, and dilated cystic lump with peripheral enhancement in the right epididymis (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Bilateral tubo-ovarian TB in a 15-year-old-female with pelvic pain. Axial pre-contrast T1 weighted (a), post-contrast T1 weighted (b), and T2 weighted (c) MR images show bilaterally enlarged ovary (stars) and dilated fallopian tubes (arrowheads). On T2-weighted MR image obtained after antituberculous therapy of 10 months, bilateral ovaries (arrows) and fallopian tubes (not shown) appear normal (d)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Bilaterally hydrosalpinx (right: blue arrows, left: red arrow) and ascites (stars) in the peritoneal cavity are observed on coronal contrast-enhancement CT images (a, b) of the same patient (in Fig. 41)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 35-year-old male. Magnetic resonance cholangiopancreatography (MRCP) images (a, b) show extensive multifocal intrahepatic biliary strictures (arrows) and dilated common hepatic duct (star)
Extrapulmonary
tuberculosıs: an old but resurgent problem. A 41-year-old male with pain in the posterior neck region. Non-contrast axial CT image (a) demonstrates destruction and bone erosion of the posterior spinous process of the C7 vertebra (arrowheads). Pre-contrast sagittal T1 weighted image (b) reveals diffuse decreased signal intensity within the c7 vertebral body and posterior spinous process. The lesion shows prominent diffuse contrast enhancement on sagittal (c) T1-weighted images (stars)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Sagittal-reformatted abdomen CT image of a 22-year-old female with lower abdominal pain and fever obtained after C/S surgery. The uterus is enlarged due to prior pregnancy. Free fluid is noted in the pelvis (arrows). Tuberculous pelvic inflammatory disease
Extrapulmonary
tuberculosıs: an old but resurgent problem. Pelvic x-ray of a 46-year-old male. The late finding of tuberculous sacroiliitis is characterized by degenerative changes in the left sacroiliac joint (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of a 43-year-old male. Pre-contrast T1 weighted (a) and post-contrast (b) T1 weighted images demonstrate contrast enhancement in the synovium of the left sacroiliac joint in keeping with acute sacroiliitis (arrows). Arrowhead shows an abscess formation in the left iliac muscle that enhances peripherally after contrast injection
Extrapulmonary
tuberculosıs: an old but resurgent problem. Coronal (a) and sagittal (b) reformatted CT images of a 70-year-old female who has a complaint of swelling in the anterior wall of the chest. Both images reveal mass-like lesions in the right sternoclavicular joint, causing bone destruction containing small calcified areas. The patient was diagnosed with TB after the biopsy
Extrapulmonary
tuberculosıs: an old but resurgent problem. Pelvic X-ray of a 53-year-old female. The left hip joint sequela of TB is characterized by degenerative arthritis (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. CT (a) and lateral ankle direct X-ray (b) images of two different patients. Lytic areas are observed in the tibia in both cases with proven tuberculous osteomyelitis and abscess
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of a 59-year-old male. Pre-contrast (a) and postcontrast (b) T1 weighted images demonstrate intraosseous (arrowheads) and soft tissue abscesses (arrow) in the distal part of the tibia and plantar face of the foot
Extrapulmonary
tuberculosıs: an old but resurgent problem. Sagittal reformatted CT (a) and MR images (b–d) of a 48-year-old male. CT image shows focal low-attenuation areas in the distal part of the tibia in keeping with abscesses and bone destructions (arrowheads). On sagittal T2-weighted (b), pre-contrast T1-weighted (c), and post-contrast T1 weighted (d) MR images reveal extensive signal intensity change within the bone marrow of the talus and distal tibial part (stars). MR images also demonstrate an abscess in the adjacent soft tissue to the Achilles tendon (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. MR images of a 60-year-old male. Pre-contrast axial (a), post-contrast axial (b), and sagittal (c) T1 weighted images reveal intraosseous abscesses (arrowheads) with peripheral enhancement in the distal part of the femur and proximal tibia
Extrapulmonary
tuberculosıs: an old but resurgent problem. A contrast-enhanced CT image of a 69-year-old male demonstrates the left iliopsoas abscess (arrows)
Extrapulmonary
tuberculosıs: an old but resurgent problem. Contrast-enhanced T1 weighted axial MR image of a 52-year-old male appears an inflammatory mass lesion within the adjacent soft tissues to the body of the fourth lumbar vertebra be caused by a phlegmon and abscess
Extrapulmonary
tuberculosıs: an old but resurgent problem. A coronal contrast-enhanced CT image of a 43-year-old male shows multiple hypodense lesions (arrows) in the liver and spleen. Hepatic and splenic TB
Extrapulmonary
tuberculosıs: an old but resurgent problem. Abdominal CT scan and MR images of the same patient (in Fig. 27). Contrast-enhanced CT (a) and T1 weighted contrast-enhanced MR images (b) show a small abscess formation with rim-like enhancement in the anterior subcapsular region of the liver. Diffusion-weighted images (DWI) (c) and apparent diffusion coefficient (ADC) map (d) reveal diffusion restriction consistent with an abscess
Extrapulmonary
tuberculosıs: an old but resurgent problem. Axial contrast-enhanced CT (a), axial T2 weighted (b), pre (c), and post-contrast T1 (d) weighted images of a 69-year-old female. Biloculated abscess formation is seen in the anterior left paramedian region of the neck, which shows peripheral enhancement
Extrapulmonary
tuberculosis • Pott's spine - Ganzer Fall bei Radiopaedia
Extrapulmonary tuberculosis (TB) refers to the haematogenous spread of Mycobacterium tuberculosis.
Pathology
Extrapulmonary tuberculosis can occur as a primary form of the disease, i.e. direct infection of an extrapulmonary organ without the presence of primary pulmonary tuberculosis or it can occur as a result of the spread of primary pulmonary tuberculosis.
It appears classically as tuberculous granulomata (tuberculomas) within the affected organs. However, certain forms of the disease exist manifesting with specific findings:
- CNS
- tuberculous meningitis
- tuberculous pachymeningitis
- intracranial tuberculous granuloma (tuberculoma)
- focal tuberculous cerebritis
- intracranial tuberculous abscess
- tuberculous rhombencephalitis
- tuberculous encephalopathy
- head and neck
- musculoskeletal
- abdominal tuberculosis
- gastrointestinal tuberculosis
- esophageal tuberculosis
- gastric tuberculosis
- duodenal tuberculosis
- jejunal and ileal tuberculosis
- ileocecal tuberculosis
- colorectal tuberculosis
- tuberculous peritonitis
- tubercular lymphadenopathy
- visceral tuberculosis
- hepatic tuberculosis
- gallbladder tuberculosis
- pancreatic tuberculosis
- splenic tuberculosis
- genitourinary tuberculosis
- renal tuberculosis
- bladder and ureteric tuberculosis
- prostatic tuberculosis
- scrotal tuberculosis (testes, epididymis, seminal vesicles, vas deferens)
- tuberculous pelvic inflammatory disease (female)
- gastrointestinal tuberculosis
Radiographic features
Widely variable dependent on the site of involvement. It is best to refer to site-specific articles.
As tuberculous organ infection can mimic malignant disease recent studies have reported the usefulness of FDG PET-CT in evaluating and following up patients in whom the diagnosis is in doubt .
Siehe auch:
- Tuberkulose
- pulmonale Tuberkulose
- Pleuraplaques
- Miliartuberkulose
- Tuberkulose des ZNS
- Nierentuberkulose
- pleurale Tuberkulose
- miliare Lungenherde
- Kavernöse Lungenläsionen
- tuberkulöse Spondylitis
- Tuberkulose des Peritoneums
- primary pulmonary tuberculosis
- tuberkulöse Halslymphknoten
- skelettale Tuberkulose
- post primary pulmonary tuberculosis
- urogenitale Tuberkulose
- Pleuritis exsudativa
- muskuloskelettale Tuberkulose
- post-primary pulmonary tuberculosis
- mutifocal skeletal tuberculosis
- Tuberkulose der Mamma
- pelvine Tuberkulose
- tuberkulöse Meningitis
- tuberkulöse Otomastoiditis
Assoziationen und Differentialdiagnosen zu extrapulmonale Manifestationen der Tuberkulose:
