Chest radiograph demonstrated fibronodular
changes in his left upper lobe.
Table 1 Chief Complaints Number of cases Percentage (%) Fever 57 63.33 Cough 51 56.66 Haemoptysis 21 23.33 Breathlessness 6 6.66 Weight loss 6 6.66 Chest Pain 3 3.33 Table 2 Findings Number of cases Percentage (%) Consolidation 36 40 Fibronodular
changes 9 10 Fibrocavitary changes 21 23.33 Acinar nodules 21 23.33 Cavities 33 36.66 Lobar collapse 3 3.33 miliary mottling 15 11.66 Pleural thickening 18 20.00 Pleural effusion 12 13.33 Mediastinal lymphadenopathy 18 20.00 Table 3 Major Groups Number of cases Predominant Parenchymal excluding military 57 Predominant Miliary Parenchymal 15 Pleural effusion 9 Mediastinal lymphadenopathy 9 Pulmonary tuberculosis- Major groups.
changes with cavities and scarring, mimicking tuberculosis or histoplasmosis, can occur but is not common.
The International Unit Against Tuberculosis (IUAT) trial, conducted in Eastern Europe, randomized approximately 28,000 individuals with positive tuberculin skin tests (TST) and fibronodular
changes on chest X-ray (12).
A chest radiograph revealed a dense infiltrate in the posterior segment of the right upper lung, extensive fibronodular
disease and decreased volume.
Patchy areas of fibronodular
changes are noted in left lower lobe with tractional and tubular bronchiectasis in bilateral lung fields (Figure 4).
Examples include apical tuberculous fibronodular
changes, symmetric bilateral ground glass opacities in pneumocystis jiroveci pneumonia, cavitary filling defects of aspergillomas, hepatic and pulmonary hydatid cysts, and pleuroparenchymal changes in paragonimiasis, all of which may calcify, rarely in some cases.