[Clinical and radiological features of pulmonary tuberculosis manifested as interstitial lung diseases.].
OBJECTIVE
The purpose of this paper was to investigate the clinical and radiological features of pulmonary tuberculosis presenting as interstitial lung diseases (ILD).


METHODS
We analyzed the data of cases suspected of diffuse parenchyma lung diseases at this hospital between October 2003 and October 2007. The diagnosis of active pulmonary tuberculosis was based on epithelioid granuloma or positive acid-fast bacilli in lung biopsy and changes on serial radiographs obtained during treatment.


RESULTS
The data of a series of 230 consecutive patients with suspected ILD were retrospectively analyzed. The diagnosis was confirmed by lung biopsy. Twelve patients were confirmed to have pulmonary tuberculosis. There were 5 males and 7 females with a mean age of 38 +/- 11 years (range, 17 - 68). The median course of disease in these patients was 3 months (range, 0.5 - 18 months). Patients with pulmonary tuberculosis presented with fever (11/12), cough (9/12), weight loss (7/12), dyspnea (7/12), lymphadenopathy (4/12), and splenohepatomegaly (2/12). On chest CT scan, ground-glass attenuation was identified in 4, bilateral patchy infiltration in 5, tree-in-bud appearance 1, and centrilobular lesions in 2 of the 12 patients. During the follow-up period (median, 9 month, range from 3 to 12 month), 11 patients improved, but 1 died of diabetic ketoacidosis.


CONCLUSIONS
The diagnosis of pulmonary tuberculosis should be considered in suspected ILD patients presenting with fever, splenohepatomegaly and lymphadenopathy.
Shi
Ju-Hong
JH
Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
Feng
Rui-E
RE
Tian
Xin-Lun
XL
Xu
Wen-Bing
WB
Xu
Zuo-Jun
ZJ
Liu
Hong-Rui
HR
Zhu
Yuan-Jue
YJ
D001706:Biopsy; D006801:Humans; D008168:Lung; D017563:Lung Diseases, Interstitial; D014376:Tuberculosis; D014397:Tuberculosis, Pulmonary