Role of Chest Imaging in Clinically Suspected Extrapulmonary Tuberculosis Without any Chest Symptoms

Authors

  • Sumit Kumar Department of Radiodiagnosis, UCMS and GTBH, Delhi, India
  • Aishwarya Naik Department of Radiodiagnosis, GB Pant Hospital, Delhi, India
  • Vinita Rathi Department of Radiodiagnosis, UCMS and GTBH, Delhi, India
  • Anupama Tandon Department of Radiodiagnosis, UCMS and GTBH, Delhi, India

DOI:

https://doi.org/10.55489/njmr.150320251136

Keywords:

Extrapulmonary Tuberculosis, Tuberculosis, Chest X Ray

Abstract

Background: Establishing a definitive diagnosis of EPTB can be very difficult in resource limited developing countries. Objective: To assess whether chest imaging (chest radiograph and/or CT chest) can play a significant role in the diagnosis of suspected EPTB.

Methodology: Observational study was conducted in 120 patients of suspected EPTB who underwent radiography, sonography, or CT scan: or presented for review of any imaging studies done for EPTB. Chest Radiograph (CR) and CECT chest requested in these patients, who did not have pulmonary symptoms, were evaluated for tubercular infection.

Results: The commonest EPTB encountered among 120 patients was abdominal tuberculosis in 44/120 patients (36.66%). Chest Radiograph suggested pulmonary TB in 48 out of 112 patients (42.85%) with suspected EPTB and 24 out of 32 patients (75%) who underwent CECT chest. In 56 out of 120 patients (46.66%), pulmonary TB was observed on combined chest imaging (CR + CECT Chest). The commonest CR finding in patients with suspected EPTB was lymphadenopathy in 32 patients (66.66%). The commonest lung abnormalities on CECT chest were tree-in-bud opacities in 20 out of 32 patients (62.5%), and matted, necrotic mediastinal lymph nodes were also seen in 20 patients (62.5%).

Conclusion: Chest imaging can play a significant role in confirming diagnosis in 46% of suspected EPTB cases in whom available laboratory investigations are equivocal.

References

Gambhir S, Mudalsha R, Rangan K, Dixit M, Barai S, Bomanji J. Imaging in extrapulmonary tuberculosis. International Journal of Infectious Diseases.2017; 56:237-47. DOI: https://doi.org/10.1016/j.ijid.2016.11.003 PMid:27838445 DOI: https://doi.org/10.1016/j.ijid.2016.11.003

Westra SJ, Yikilmaz A, Lee EY. Pulmonary Infection. In: Coley BD. ed. Caffey's Paediatric Diagnostic Imaging 13th ed, Elsevier, North America;2019: pp 521.

Maulahela H, Simadibrata M, Nelwan EJ, Rahadiani N, Renesteen E, Suwarti SWT et al. Recent advances in the diagnosis of intestinal tuberculosis. BioMed Central Gastroenterology.2022;22(1):89. DOI: https://doi.org/10.1186/s12876-022-02171-7 PMid:35227196 PMCid:PMC8885312 DOI: https://doi.org/10.1186/s12876-022-02171-7

Herath S, Lewis C. Pulmonary involvement in patients presenting with extra-pulmonary tuberculosis: thinking beyond a normal chest x-ray. J Prim Health Care.2014; 6:64-8. DOI: https://doi.org/10.1071/HC14064 PMid:24624413 DOI: https://doi.org/10.1071/HC14064

Velingker A, Lawande D, Dcosta L. Clinico-epidemiological profile of extra pulmonary tuberculosis in Western India. International Journal of Contemporary Medical Research.2018;5:B1-B4.

Gupta KB, Jose M, Chaudhary U, Magu S. Pulmonary involvement in extrapulmonary tuberculosis patients. European Respiratory Journal. 2011;38(Suppl 55):p2705.

Nachiappan AC, Rahbar K, Shi X, Guy ES, Mortani Barbosa EJ Jr, Shroff GS, Ocazionez D, Schlesinger AE, Katz SI, Hammer MM. Pulmonary Tuberculosis: Role of Radiology in Diagnosis and Management. Radiographics. 2017 Jan-Feb;37(1):52-72. DOI: https://doi.org/10.1148/rg.2017160032 PMid:28076011 DOI: https://doi.org/10.1148/rg.2017160032

Arega B, Mersha A, Minda A et al. Epidemiology and the diagnostic challenge of extra-pulmonary tuberculosis in a teaching hospital in Ethiopia.PLOS ONE.2020;15: e0243945. DOI: https://doi.org/10.1371/journal.pone.0243945 PMid:33320897 PMCid:PMC7737896 DOI: https://doi.org/10.1371/journal.pone.0243945

El-Hazmi MM, Al-Otaibi FE. Predictors of pulmonary involvement in patients with extra-pulmonary tuberculosis. J Family Community Med. 2012;19:88-92. DOI: https://doi.org/10.4103/2230-8229.98287 PMid:22870411 PMCid:PMC3410185 DOI: https://doi.org/10.4103/2230-8229.98287

Chao-Jung Wei, Chui-Mei Tiu, Jen-Dar Chen, Yi-Hong Chou, Cheng-Yen Chang, Chun Yu. Computed tomography features acute pulmonary tuberculosis. The American Journal of Emergency Medicine; 2004:171-4. DOI: https://doi.org/10.1016/j.ajem.2004.02.004 PMid:15138951 DOI: https://doi.org/10.1016/j.ajem.2004.02.004

Garg MK, Kalra N. Radiological manifestations of pulmonary tuberculosis. In: Diagnostic Radiology 3rd edition ed. Chowdhury V, Gupta AK, Khandelwal N. Jaypee Brother Medical Publishers, New Delhi, India.2010; pp.60-8. DOI: https://doi.org/10.5005/jp/books/11433_4 DOI: https://doi.org/10.5005/jp/books/11433_4

Downloads

Published

2025-07-01

How to Cite

Kumar, S., Naik, A., Rathi, V., & Tandon, A. (2025). Role of Chest Imaging in Clinically Suspected Extrapulmonary Tuberculosis Without any Chest Symptoms. National Journal of Medical Research, 15(03), 194–201. https://doi.org/10.55489/njmr.150320251136

Issue

Section

Original Research Articles