X-ray manifestations of pulmonary tuberculosis

Many people are infected with tuberculosis because they did not take their previous colds and coughs seriously, which resulted in continuous coughing and eventually coughing up blood, which led to serious lung infection and tuberculosis. Some tuberculosis patients are infected, mostly because they have used the same tableware with the pathogen or talked face to face. So what are the X-ray manifestations of tuberculosis?

Pulmonary tuberculosis is a common chronic infectious disease of the lungs. Its early symptoms are mild, such as low fever, fatigue, cough, and sputum. Some patients may have no symptoms. Therefore, routine X-ray examinations are of great value in the diagnosis, prevention and treatment of tuberculosis. Tuberculosis bacteria can spread along the bronchi to other lung tissues (bronchial dissemination), enter the blood through the lymphatic vessels, flow through the right heart, and the pulmonary artery to form intrapulmonary hematogenous dissemination, directly invade the veins to form systemic hematogenous dissemination, and the lesions can also infiltrate into adjacent lung tissues.

Tuberculosis classification:

1. Primary pulmonary tuberculosis (code: Type I): Primary pulmonary tuberculosis is a clinical disease caused by primary tuberculosis infection. Includes primary syndrome and intrathoracic lymph node tuberculosis.

2. Hematogenously disseminated pulmonary tuberculosis (code: Type II): This type includes acute hematogenously disseminated pulmonary tuberculosis (acute miliary tuberculosis) and subacute and chronic hematogenously disseminated pulmonary tuberculosis. X-ray manifestations: (a) Primary pulmonary tuberculosis (code: Type I): This is the first infection of tuberculosis, which is more common in children. The clinical symptoms are not obvious, sometimes with low fever in the afternoon, night sweats, weight loss and weakness, cough, etc. There are generally no positive signs during physical examination. For example, when there is exudative evidence around the lesion or atelectasis, there may be dullness on percussion, low breath sounds or rales.

⑴ Primary syndrome: When Mycobacterium tuberculosis invades the lung tissue, exudative lesions occur in the lungs within a few weeks, which are called primary lesions, and a more extensive nonspecific perilesional inflammation may occur around them. The primary lesion can spread along the lymphatic vessels to the intrapulmonary lymph nodes, causing lymphangitis and lymphadenitis. Therefore, the primary syndrome is composed of the primary lesion, lymphangitis and lymphadenitis, which is a typical manifestation of primary pulmonary tuberculosis.

⑵ Intrathoracic lymph node tuberculosis: In some primary syndromes, the primary lesions in the lungs have been absorbed or fibrotic or are small and cannot be shown on X-rays. The caseous necrosis in the lymph nodes is severe and their healing is slower than that of the primary lesions. Alternatively, the lymph node lesions continue to develop, resulting in obvious enlargement of the hilar or mediastinal lymph nodes.