Analysis of Atypical X-ray and CT Findings and Misdiagnosis of Pulmonary Tuberculosis in Aged Patients

Objective To improve the knowledge of X-ray and CT findings of atypical pulmonary tuberculosis(APT) in aged patients and to analyse its reason of misdiagnosis.Methods There were 60 cases of APT.All of them were diagnosed definitely through surgery andpathology,the age ranged from 60 to 80 years(mean 67 years).There were 32 males and 28 females.All of them took the frontal chestradiography,48 had additional lateral chest radiography,23 had additional CT scanning and 14 underwent bronchial fube endoscope.Biopsy of puncture was performed in 12 cases .The chest films were analyzed in a blinded manner.Results There was 14 nodule or mass type,of them,the edge of mass was smooth in 11 cases and lobular in 3 cases,12 were endobronchial tuberculosis,segmental conslidation and lobulartype in 6 cases respectively,6 tuberculosis cavity,5 tubercalomas of lower lobe,4 multiple tuberculoma and 3 miliary tuberculosis type.22cases were misdiagnosed as pulmonary carcinoma 12,inflammation 4,metastasis 2,alveolar carcinoma 1 ,pulmonary atelectasis 2 andinflammatory psudoumor of the lung 1.Conclusion The imaging features of APT in aged patients are atypical,the symptoms position and shape of lesions are also atypical.All kinds of the main reasons of misdiagnosis include excessively dependence on certain radiological signs and ignorance of clinical manifestation.