The following are examples of how Active TB may look on CXR:
Large RUL Nodule
Small R Apical Nodule
RUL Cavity
RUL Cavity
Obvious Bilateral Upper Lobe Infiltrates
Subtle Left Apical Infiltrate (fuzzy spot overlying clavicle)
Primary TB – LLL Infiltrate.
Mimics any pneumonia; occurs in debilitated pts, when Mtb first enters lung, and innate immune system unable to contain it.
TB in advanced AIDS
Paratracheal / Mediastinal Adenopathy. Clear lungs.
A CXR reading of “calcified granulomas” is NOT active. Merely the burnt-out remnants of where Mtb first entered the lungs. Simply Latent TB Infection; address the same as a positive PPD / IGRA with “normal CXR”.
Calcified nodules in a) periphery of lower aspect of RUL; and b) R hilum.
A reading of “old scar” or “old granulomatous disease, not active” is WRONG unless there’s mention of a prior comparison film with “no change” or “stability”.
Impossible to distinguish R apical “old scar” from “active TB” w/o a prior comparison.
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DiagnosisDude 