CTICasesDisseminated Tuberculosis (Pott's Disease and Mimicking Sarcoidosis)
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Imaging findings
Chest CT shows symmetric, upper-lobe predominant peribronchovascular fibrosis with traction bronchiectasis, mimicking end-stage sarcoidosis. Cervical spine CT shows C6-C7 disc-centered osteolytic destruction and a large paraspinal soft-tissue abscess. Abdomen and pelvis CT shows a massive, destructive fluid collection (cold abscess) extending from the sacrum and sacroiliac joint through the iliopsoas and gluteal muscles, with an osseous sequestrum in the ilium.
Key takeaways
Disseminated tuberculosis can present with musculoskeletal manifestations, including tuberculous spondylodiscitis (Pott's disease) and large, cold paraspinal or psoas abscesses with bone destruction. The associated pulmonary changes can occasionally be highly symmetric and fibrotic, closely mimicking sarcoidosis and potentially leading to a delayed diagnosis of TB if spinal and abdominal symptoms are not synthesized.
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