Imaging diagnosis and differential diagnosis of hematogenous disseminated pulmonary tuberculosis in children / 中华实用儿科临床杂志

ABSTRACT

Tuberculosis is in the top 10 fatal disease in the world.Mycobacterium tuberculosis can easily spread through blood and affect all organs of the body.Children are susceptible to tuberculosis, most of which is acute hematogenous disseminated tuberculosis, including some congenital tuberculosis.The imaging features of acute hema-togenous disseminated pulmonary tuberculosis are miliary nodules/nodules of the same size and evenly and randomly distributed and dispersed in both lungs, accompanied by hilar and mediastinal adenopathy and calcification.Young children with hematogenous disseminated tuberculosis have relatively large nodules which easy to fuse.The imaging features of subacute/chronic hematogenous disseminated pulmonary tuberculosis are randomly distributed nodules with different sizes and densities as well as mixed exudative and proliferative lesions.Congenital tuberculosis usually occurs in neonates within 1 month characterized by diffuse miliary nodules or consolidation lesions.The lesions can be fused, accompanied by mediastinum and hilar adenopathy.The differential diagnosis of pediatric hematogenous disseminated pulmonary tuberculosis in infants includes chronic granulomatosis and chlamydia pneumonia, and in old children includes cryptococcus pneumonia, staphylococcus aureus pneumonia, hematogenous pulmonary aspergillosis, tracheobronchial tuberculosis, allergic pneumonia, cytomegalovirus pneumonia, lung Langerhans histiocytosis, pulmonary metastasis, pulmonary lymphangiomatosis, pulmonary lymphoproliferative diseases, idiopathic pulmonary hemosiderosis, Niemann Pick′s disease, etc.The classification and imaging characteristics of children′s hematogenous disseminated tuberculosis were systematically studied and summarized in this review, and the diagnosis and differential diagnosis of hematogenous disseminated tuberculosis in children was reviewed based on the author′s clinical experience, in order to improve the imaging recognition and diagnosis of the disease.