J Korean Soc Radiol.  2011 Dec;65(6):585-588. 10.3348/jksr.2011.65.6.585.

An Unusual Radiologic Manifestation of Pulmonary Tuberculosis with Bilateral Multiple Lung Nodules and Diffuse Alveolar Hemorrhage: A Case Report

• Jeong SI
• Seon HJ
• Choi S
• Kim YH

• KMID: 2002926
• DOI: http://doi.org/10.3348/jksr.2011.65.6.585

Abstract

Pulmonary tuberculosis presenting as bilateral multiple lung nodules or diffuse alveolar hemorrhage is very rare. Here, we report a case of pulmonary tuberculosis presenting as bilateral multiple lung nodules and diffuse alveolar hemorrhage mimicking granulomatous vasculitis, such as Wegener's granulomatosis.

MeSH Terms

Hemorrhage
Lung
Multiple Pulmonary Nodules
Tuberculosis, Pulmonary
Vasculitis
Wegener Granulomatosis

Figure

• 

  Fig. 1 A 70-year-old man with pulmonary tuberculosis. A. Initial chest PA radiogram shows multiple nodular opacities with mildly and diffusely increased opacity in both lungs and consolidation in right lower lung. B, C. Initial chest CT scan shows multiple bilateral nodules with ground glass attenuation halo (white arrows in B, C) mixed with crazy-paving pattern lesions (arrowheads in C) in both lung fields with more prominent involvement in the both lower lobes. Focal area of fibrotic old inflammatory lesion suggesting inactive pulmonary tuberculosis is also shown in posterior segment of right upper lobe (black arrows in B). D. Follow up chest PA radiogram after anti-tuberculosis medication shows improvement of multiple nodular opacities in both lungs and consolidation in right lower lung. E, F. Follow up chest CT after anti-tuberculosis medication shows complete improvement of multiple bilateral nodules and crazy-paving pattern lesions in both lungs with remained focal area of fibrotic old inflammatory lesion in posterior segment of RUL (black arrows in E). Note.-PA = posteroanterior

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