title: Pulmonary Tuberculosis in Patients With Emphysema: Computed Tomography Findings.
abstract: OBJECTIVE
  To evaluate the computed tomography (CT) findings and clinical characteristics of pulmonary tuberculosis (TB) in patients with emphysema, compared with those without emphysema.
  
  
  METHODS
  Thirty-nine patients (M:F = 36:3; mean age, 64.8 years) who were diagnosed with chronic obstructive pulmonary disease and had emphysema in pretreatment chest CT scans were included in this study (emphysema group). Their clinical presentation, laboratory findings, and CT findings were compared with those of 57 pulmonary TB patients without chronic obstructive pulmonary disease and emphysema (M:F = 52:5; mean age, 64.3 years) (nonemphysema group).
  
  
  RESULTS
  Fever was a more frequent clinical presentation and the C-reactive protein level was higher in the emphysema group. Among CT findings, consolidation and ground-glass opacity were seen more frequently in the emphysema group (82% and 69% vs 42% and 19%, respectively, P < 0.001). Consolidation was more often nonsegmental than lobular or segmental. Tree-in-bud appearance was less frequently noted in the emphysema group (36% vs 79%, P < 0.001). The location of main lesions (upper lung vs middle/lower lung) was not different between the 2 groups.
  
  
  CONCLUSIONS
  Pulmonary TB in emphysema patients often shows bacterial pneumonia-like features, that is, presence of consolidation and ground-glass opacity and lack of bronchogenic spread on chest CT scans, combined with the presence of fever and a high C-reactive protein level. Sputum smear for acid-fast bacteria should be performed early in emphysema patients with pneumonia in TB-endemic areas.
authors.affiliation: From the *Department of Radiology, Gyeongsang National University School of Medicine, Jinju; †Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon; ‡Department of Radiology, Gyeongsang National University Hospital, Jinju; and § Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
authors.forename: Kyung Nyeo
authors.initials: KN
authors.lastname: Jeon
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Ha
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Park
authors.forename: Kyungsoo
authors.initials: K
authors.lastname: Bae
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Baek
authors.forename: Bo Hwa
authors.initials: BH
authors.lastname: Choi
authors.forename: Soo Buem
authors.initials: SB
authors.lastname: Cho
authors.forename: Jin Il
authors.initials: JI
authors.lastname: Moon
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology*