CTICasesPulmonary Tuberculosis (Nodular Presentation)
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Imaging findings
CT of the chest demonstrates a cluster of nodules with smaller satellite nodules and surrounding ground-glass opacity in the left upper lobe, with no evidence of cavitation. These findings correspond to an incidental area of abnormal signal intensity originally identified on scout images of an abdominal MRI performed for hepatocellular carcinoma screening.
Key takeaways
Tuberculosis can present as an isolated, asymptomatic cluster of non-cavitating nodules that mimic primary lung cancer or metastasis on imaging, especially in cirrhotic patients undergoing routine screening. A high index of suspicion, positive interferon-gamma release assays (QuantiFERON-Gold), and sputum cultures are required to make the diagnosis in these atypical, clinically silent cases.
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