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PNEUMONIA

John Kurniawan
1. TUBERCULOSIS (TBC)

2. NON TBC / NON SPESIFIC


PRIMARY COMPLEX OF RANKE

CHEST X-RAYS :

 PRIMARY FOCUS ( = GHON FOCUS)


 LYMPHANGITIS
 HILAR NODES >> +/- CALCIFICATION
 PRIMARY PULMONARY TBC
PRIMARY TBC
 GHON FOCUS & RANKE COMPLEX
ACTIVE SIGNS:

CHEST X-RAYS :

 PATCHIES
 CONFLUENS  OPACITIES
 CLOUDY  HAZINESS
 CAVITY  CAVITIES
POST PRIMARY TBC ( ADULT )

CAVITY INHOMOGENEOUS OPACITY


TBC : CAVITY AT LUL
Tuberculosis Left upper lobe cavity
Left upper lobe cavity
Tuberculosis
POST PRIMARY TBC
POST PRIMARY TBC
Thin-walled with smooth inner margins, RUL –Tuberculosis
Simple aspergilloma

Patient RT
December 2002

Cough (mild) &


tired
POST PRIMARY TBC : QUIESCENT

o FIBROSIS  RETRACTION

o CALCIFICATIONS

o CAVITAS + / -
INACTIVE (OLD) TBC:
FIBROSIS & CALCIFICATION
Residual old specific inflammatory process

PA chest X-ray examination: In the apex of the left upper lobe, several small,
round nodules, with the intensity of soft tissue can be seen (arrow), with an
increased reticular pattern in the surroundings, due to fibrosis.
OLD / INACTIVE TBC
TBC COMPLICATION : MILIAR TBC
Miliary Tuberculosis

 Interstitial granules

o Uniform size
o Sharper edges
Miliary Tuberculosis
Miliary shadowing
TBC COMPLICATION : Tuberculosis Spine

 Loss of intervertebral space

 Vertebral collapse

Cold abscess is not present in this case.


PA view is not diagnostic.
SPONDYLITIS TBC
& PARA VERTEBRAL ABSCESS
 RELATIVELY HOMOGENOUS CONSOLIDATION

 CLOUDY , HAZINESS  LOBAR / SEGMENTALS .

 SHARP BORDER

 AIR BRONCHOGRAM SIGN (ABS + / - )

 SILHOUETE SIGN ( + / - )

 TENDENCY TO THE LOWER / MIDDLE LOBES


RUL pneumonia

The black branching


structures are the result
of air in the bronchi, now
visible because density
other than air surrounds
them (in this case it is
inflammatory exudate
from a pneumonia).
• RML pneumonia PA and LAT CXR demonstrate
consolidation in the right middle

Primary involves alveoli / Spreads through pores of Kohn throughout


a segment or lobe, but not totally.
Bronchi are not primary affected  air bronchograms
RLL pneumonia
LUL pneumonia
LUL pneumonia
LLL pneumonia
AIR BRONCHOGRAM SIGN ( ABS )

PNEUMONIA / HMD
Round Pneumonia
Round pneumonia

PA and LAT CXR shows a round opacity in the superior segment of the
right lower lobe which has the appearance of a mass.
Airspace Disease
Aspiration pneumonia
RIGHT PLEUROPNEUMONIA

PNEUMONIA

PLEURAL EFFUSION
CHEST X-RAYS DENSITIES

TENDENCY TO THE LOWER LOBE


Bronchopneumonia
Primary affects the bronchi and adjacent alveoli
 Bronchial spread results in multifocal patchy opacities.
Bronchi fill with exudate causing of volume loss.
BILATERAL BRONCHOPNEUMONIA
PATCHIES

IRREGULAR SCATTERED
BRONCHOPNEUMONIA