title: [Thoracic manifestation of tuberculosis].
abstract: OBJECTIVE
  Tuberculosis (TB) is a granulomatous disease caused by Mycobacterium tuberculosis and transmission is via an airborne route by droplet infection. In the majority of cases patients have thoracic TB, which most frequently presents with hilar lymphadenopathy and pulmonary manifestation. Due to the rise in incidence of TB in central Europe to be expected over the coming years, it is essential to be acquainted with the radiological manifestations of pulmonary TB, particularly to be able to discriminate active from inactive TB. Due to the use of molecular techniques entailing DNA fingerprinting, the traditional classification of TB in primary and postprimary TB is being challenged. These genetic studies have revealed that variations in the clinical and radiographic appearance of TB are mainly affected by the immune status of the patients. Due to the low prevalence of TB in central Europe and the wide variation of radiological presentations, the diagnosis and therapy of TB is often delayed. In this article, the radiographic manifestations of thoracic TB are summarized and discussed.
  
  
  METHODS
  Together with the medical history and bacteriological tests, chest X‑ray imaging and computed tomography (CT) play a major role not only in the detection of TB but also in the follow-up during and after therapy.
  
  
  CONCLUSIONS
  Chest X‑radiographs should be the primary diagnostic method in patients with suspected TB in screening as well as for diagnosis and therapy monitoring. The use of CT is more sensitive than chest radiographs and is frequently performed after chest radiographs to obtain detailed information about subtle parenchymal changes or lymph node manifestation. When active TB is suspected CT should be performed. Tree in bud, lobular consolidations, centrilobular nodules, cavities and ground-glass opacification are typical changes in active TB.
authors.affiliation: Abteilung für Allgemeine Radiologie und Kinderradiologie, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich. daniela.kienzl-palma@meduniwien.ac.at.
authors.forename: D
authors.initials: D
authors.lastname: Kienzl-Palma
authors.affiliation: Abteilung für Allgemeine Radiologie und Kinderradiologie, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: H
authors.initials: H
authors.lastname: Prosch
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D000072281:Lymphadenopathy / Q000000981:diagnostic imaging* / Q000473:pathology; D013902:Radiography, Thoracic / Q000379:methods*; D013896:Thoracic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014376:Tuberculosis / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Caseating granuloma; Chest radiograph; Computed tomography; Granulomatous systemic disease; Lymphadenopathy