Subpleural nodules and septal thickening on CT chest may predict tubercular pleural effusion

They explained that common CT (computed tomography) findings in TB pleural effusion are Subpleural micronodules and interlobular septal thickening. These features detected in computed tomography could aid in the differentiation between TB pleural effusion and non-tuberculous empyema.

The main question here is whether subpleural micronodules and interlobular septal thickening frequency correlate with the pleural effusion presence in pulmonary TB patients.

In this study, CT findings of pulmonary TB, micronodules and their distribution, large opacity, cavitation, tree-in-buds, bronchovascular bundle thickening, interlobular septal thickening, lymphadenopathy, and pleural effusion were retrospectively analyzed.

Patients were divided into two groups based on pleural effusion presence, and Clinicoradiological findings were then analyzed.

The key results of the study are:

• 338 patients were diagnosed with pulmonary TB who underwent a CT scan.
• Due to co-existing pulmonary diseases, 60 were excluded.
• In comparison to patients in the group without pleural effusion, The frequency of subpleural nodules (69% vs. 14% for with and without effusion) and interlobular septal thickening (81% vs. 64%) was higher in the group of patients with pulmonary TB with pleural effusion.
• In pulmonary TB patients with pleural effusion, tree-in-buds (29% vs 48%) were less frequently seen in patients with Interpretation.

They said we found that Subpleural nodules and septal thickening are more common in pulmonary TB patients with pleural effusion. Based on the findings in our study, TB involvement of the lymphatics in the peripheral interstitium may be associated with the development of pleural effusion.

Further reading:

https://www.sciencedirect.com/science/article/abs/pii/S0012369223009534