title: High-resolution CT findings of pulmonary Mycobacterium tuberculosis infection in renal transplant recipients.
abstract: OBJECTIVE
  Renal transplantation recipients are at increased risk of Mycobacterium tuberculosis infection because of immunosuppression. The aim of this study was to assess high-resolution CT (HRCT) findings in renal transplantation recipients diagnosed with pulmonary tuberculosis (TB).
  
  
  METHODS
  We reviewed HRCT findings from patients diagnosed with pulmonary TB, established by M. tuberculosis detection in bronchoalveolar lavage, sputum or biopsy sample. Two observers independently reviewed HRCT images and reached consensus decisions on the presence and distribution of: (i) miliary nodules, (ii) cavitation and centrilobular tree-in-bud nodules, (iii) ground-glass attenuation and consolidation, (iv) mediastinal lymph node enlargement and (v) pleural effusion.
  
  
  RESULTS
  The sample comprised 40 patients [26 males, 14 females; median age, 45 years (range, 12-69 years)]. The main HRCT pattern was miliary nodules (40%), followed by cavitation and centrilobular tree-in-bud nodules (22.5%), ground-glass attenuation and consolidation (15%), mediastinal lymph node enlargement (12.5%) and pleural effusion (10%). The distribution of findings in patients with miliary nodules was random. In patients with cavitation and centrilobular tree-in-bud nodules, 66.6% of abnormalities were found in the upper lobes. Pleural effusion was unilateral in 75% of cases. The overall mortality rate was 27.5%. This rate was 50% in patients with miliary nodules, and 72.6% of all deaths occurred in this group. Thus, mortality was increased significantly in patients with miliary nodules (p < 0.05).
  
  
  CONCLUSIONS
  The main HRCT finding in renal transplantation recipients with pulmonary TB was miliary nodules, followed by cavitation and centrilobular tree-in-bud nodules. Miliary nodules were associated with a worse prognosis in these patients.
  
  
  CONCLUSIONS
  We report the first series on HRCT findings of microbiologically confirmed pulmonary TB exclusively in renal transplantation recipients. The main HRCT finding was miliary nodules, and mortality was increased significantly in these patients.
authors.affiliation: 1 Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Marisa
authors.initials: M
authors.lastname: Pereira
authors.affiliation: 2 Labimed-Medical Imaging Research Lab, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)/Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil.
authors.forename: Fernando F
authors.initials: FF
authors.lastname: Gazzoni
authors.affiliation: 3 Radiology Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Marchiori
authors.affiliation: 4 Radiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Klaus
authors.initials: K
authors.lastname: Irion
authors.affiliation: 1 Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Jose
authors.initials: J
authors.lastname: Moreira
authors.affiliation: 2 Labimed-Medical Imaging Research Lab, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)/Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil.
authors.forename: Irai L
authors.initials: IL
authors.lastname: Giacomelli
authors.affiliation: 2 Labimed-Medical Imaging Research Lab, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)/Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pasqualotto
authors.affiliation: 2 Labimed-Medical Imaging Research Lab, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)/Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hochhegger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D002648:Child; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000276:immunology / Q000401:mortality