Pulmonary tuberculosis


  • A 26 years old man
  • Non-smoker with no previous medical illness
  • Presented with chronic cough and constitutional symptoms
  • Completed TB vaccination
Chest radiograph PA erect view

Radiographic findings:

  • A large cavitating lesion with surrounding consolidation is seen at the lower part of right upper lobe.
  • There are multiple small cavitating lesions involving the rest of right upper lobe.
  • No hilar mass. No mediastinal shift.
  • Other part of the lungs are clear.
  • No pleural effusion or pneumothorax. No hilar mass.
  • Cardiothoracic ratio is normal.
  • Bones and soft tissues are unremarkable.

Diagnosis: Pulmonary tuberculosis (sputum positive).


  • Tuberculosis is an airborne infectious disease caused by Mycobacterium tuberculosis
  • Cavitation is uncommon in primary tuberculosis, seen in only 10-30% if cases
  • Post-primary infections are far more likely to cavitate than primary infections. In the vast majority of cases, they develop in the posterior segments of the upper lobes (85%).
  • However, more typical appearance of post primary tuberculosis is that of patchy consolidation or poorly defined linear and nodular opacities.
  • Hilar nodal enlargement is seen in only approximately a third of cases.
  • Lobar consolidation, tuberculoma formation and miliary TB are also recognised patterns of post-primary TB but are less common.

Progress of patient:

  • Patient shows good response to treatment clinically
  • A repeat chest radiograph after two months of medical treatment shows reduction in size of the cavity

Author: radhianahassan