Chest CT Findings in Pulmonary TB with Pleural Effusion

“Does the frequency of subpleural micronodules and interlobular septal thickening correlate with the presence of pleural effusion in patients with pulmonary TB?” Researchers from South Korea sought to find an answer to this research question in a retrospective single-center study, where they analysed the presence of pleural effusion in patients with pulmonary TB in relation to CT scan findings.¹ The frequency of subpleural micronodules was examined. The distribution of micronodules (peribronchovascular, septal, subpleural, centrilobular, and random), as well as other CT scan findings such as large opacity (consolidation/macronodules), cavitation, tree-in-buds, bronchovascular bundle thickening, interlobular septal thickening, lymphadenopathy and pleural effusion were also analysed. The patients were divided into two groups based on the presence of pleural effusion, and their clinicoradiologic findings were compared.

A total of 338 patients who had been diagnosed with pulmonary TB between January 2017 and November 2019 were enrolled for this study. Sixty patients were excluded from the study due to the presence of  coexisting pulmonary diseases such as pneumonia, intrathoracic malignancy and metastasis, pulmonary edema and severe old TB.

According to the findings published in the journal Chest, the frequency of subpleural nodules was significantly higher in patients with pulmonary TB and pleural effusion (69%) compared to those without effusion (14%). Similarly, interlobular septal thickening was also more common in the group with pleural effusion (81%) compared to the group without effusion (64%). Conversely, tree-in-buds were uncommon in patients with pulmonary TB and pleural effusion (29%) than in those without effusion (48%).

Based on the analysis of CT scan findings in patients with pulmonary TB, this study shows that subpleural nodules and septal thickening were more frequently observed in patients with pleural effusion versus those without pleural effusion. This suggests a potential correlation between the development of pleural effusion and TB involvement of the pulmonary lymphatics in the peripheral interstitium. However, further research and investigation is required to establish a definitive causal relationship between these factors.

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