Radiograghic evaluation of lymphadenopathy in pulmonary tuberculosis in Northeastern, Nigeria.

BACKGROUND: There is changing pattern of presentation of tuberculosis in the era of HIV Lymphadenopathy is one of the most important manifestations of tuberculosis, hence the need for the evaluation of its radiologic patterns. METHODS: A multi-centre retrospective study of chest radiographs of 116 adult patients diagnosed bacteriologically (positive sputum smear) as pulmonary tuberculosis was conducted in the University of Maiduguri Teaching Hospital, Maiduguri, and Federal Medical Centre Nguru, in Bomo and Yobe States, Nigeria, respectively between April 2003 and March 2004. Lymphadenopathy was assessed in all the radiographs. RESULTS: Of the one hundred and sixteen radiographs of patients analyzed, there were 83 (71.6%) males and 33 (28.4%) females with mean age of 37.99 +/- 14.11 years. A total of thirty eight patients (32.7%) presented with lymphadenopathy with the highest frequency in the left hilar region (12.9%). Bilateral hilar and paratracheal lymphadenopathy were the lowest with equal percentages (4.3%). Left, right and bilateral hilar enlargement were more common in males than females (p < 0.000) and more patients had left hilar (15) than right hilar (13) enlargement (p = 0.030). Only 3 (2.6%) out of all the patients presented with lymph node calcification. CONCLUSION: In conclusion, there is a rise in the prevalence of lymphadenopathy among pulmonary tuberculosis patients when compared to a previous study done in the pre-HIV era in Nigeria.

The chest radiographic appearance and frequency distribution of cavities in pulmonary tuberculosis among adults in northeastern, Nigeria.

The aim of the study was to assess the radiographic appearance and frequency of distribution of cavitations in the lungs using chest radiographs in Northeastern. Nigeria. A multi-center retrospective study of chest radiographs of 116 adult patients diagnosed bacteriologically as pulmonary tuberculosis was conducted. The age, sex, presence of cavitations, single or multiple. thin walled or thick walled, presence of fluid level or fungal ball in the cavity and the lobar distribution of cavitations in the lungs were assessed. There were 83 (71.6%) males and 33 (28.4%) females with mean age of 37.99 +/- 14.11. A total of 58 patients (50%) presented with cavitations and no sex preponderance observed. There were more cases with multiple (38 patients = 32.8%) than single (20 patients = 17.2%) cavitations (P<0.05). Cavitations were more common in the right (28.23%) and left upper lobes and less common in the left lower and lingula (9.68%) lobes (Table 3). There were more cavitations involving the right lung (57.16%). Thirty four patients (58.62%) presented with only thick walled cavitations compared with 18 cases (31.03%) with only thin walled cavitations (P<0.05). Six patients (10.35) had both thick and thin wall cavitations. Out of the 58 patients with cavitations only 2.32% (4 cases) presented with fluid levels and 1.74% (3 cases) with fungal ball. In conclusion, cavitations are a common finding in pulmonary tuberculosis with no sex preponderance and occur predominantly in the upper lobes. Multiple, thick wall cavitations were the common presentation. Fungal balls and fluid levels were rare.