Published online before print August 16, 2002, 10.1148/radiol.2251011357
Utility of Polymerase Chain Reaction for Detecting Mycobacterium tuberculosis in Specimens from Percutaneous Transthoracic Needle Aspiration1
Eun-Young Kang, MD,
Jung-Ah Choi, MD,
Bo Kyoung Seo, MD,
Yu-Whan Oh, MD,
Chang Kyu Lee, MD and
Jae Jeong Shim, MD
1 From the Departments of Diagnostic Radiology (E.Y.K., J.A.C., B.K.S., Y.W.O.), Clinical Pathology (C.K.L.), and Internal Medicine (J.J.S.), Korea University College of Medicine, Korea University Guro Hospital, 80 Guro-dong, Guro-ku, Seoul 152-050, Korea. Received August 10, 2001; revision requested September 28; revision received December 19; accepted February 25, 2002. Address correspondence to E.Y.K. (e-mail: keyrad@korea.ac.kr).
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Figure 1. Transverse chest CT scan obtained at the level of the aortic arch in a 43-year-old man with pulmonary TB. A well-defined 2-cm-diameter nodule with a cavity (arrow) is visible in the left upper lobe. Bacteriologic results in sputum were negative. Fluoroscopy-guided PTNA was performed, and the results were negative both for malignant cells and for a histologic diagnosis of TB. Results of PCR for TB in PTNA lung aspirates were positive. This lesion showed improvement after medication for TB.
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Figure 2. Transverse contrast material-enhanced chest CT scan in a 36-year-old man with pulmonary TB shows triangular consolidation with an internal low-attenuating area (arrow) in the left upper lobe. Results of M tuberculosis culture and AFB stain with sputum were negative. US-guided PTNA was performed, and the results were negative both for malignant cells and for a histologic diagnosis of TB. Results of PCR for TB in PTNA lung aspirates were positive. Additionally, bacteriologic results with pleural fluid were positive. This lesion showed improvement after medication for TB.
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Figure 3a. Transverse chest CT scans in a 37-year-old man with adenocarcinoma. (a) A well-defined 3.5-cm-diameter mass (arrow) is present in the right upper lobe apical segment. (b) A nodule with a cavity (arrow) is visible in the left upper lobe. Numerous variable-sized small nodules are scattered in both lungs, which was suggestive of metastasis on follow-up chest radiographs and CT scans (not shown). In this patient, sputum AFB stain was positive initially (1 month before the CT scans were obtained), so medication was started, and the cavitary nodule in left upper lobe improved during 1 month. The CT diagnosis for the right upper lobe lesion was a malignant mass. Fluoroscopy-guided PTNA was performed on the right upper lobe lesion, and adenocarcinoma was diagnosed. Results of PCR for TB detection in PTNA lung aspirates were negative.
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Figure 3b. Transverse chest CT scans in a 37-year-old man with adenocarcinoma. (a) A well-defined 3.5-cm-diameter mass (arrow) is present in the right upper lobe apical segment. (b) A nodule with a cavity (arrow) is visible in the left upper lobe. Numerous variable-sized small nodules are scattered in both lungs, which was suggestive of metastasis on follow-up chest radiographs and CT scans (not shown). In this patient, sputum AFB stain was positive initially (1 month before the CT scans were obtained), so medication was started, and the cavitary nodule in left upper lobe improved during 1 month. The CT diagnosis for the right upper lobe lesion was a malignant mass. Fluoroscopy-guided PTNA was performed on the right upper lobe lesion, and adenocarcinoma was diagnosed. Results of PCR for TB detection in PTNA lung aspirates were negative.
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Copyright © 2002 by the Radiological Society of North America.
