Imaging manifestation and misdiagnosis analysis of 58 cases of adult atypical pulmonary tuberculosi

Objective To investigate the imaging features of atypical pulmonary tuberculosis, and to identify peripheral lung cancer from other mass lesions Methods The X-ray and CT imaging manifestations and misdiagnosis of 58 cases of atypical pulmonary tuberculosis were analyzed retrospectively. All the cases were confirmed by operation and or pathology. Results The clinical symptoms, X-ray and CT imaging manifestations of atypical pulmonary tuberculosis were non-specific, with the positive rate for tuberculosis bacteria of 10.3%. X-ray could only detect some abnormal shadow in lung, while CT could show certain characteristic signs. According to CT manifestations, the 58 cases of tuberculosis were divided into 31 cases of nodus or tumour type (53.4%). 12 cases of segmental or lobar consolidation-type (20.7%), 6 cases of empty-type (10.3%), 3 cases of endobronchial tuberculosis (5.2%), 3 cases of basal tuberculosis (5.2%) and 3 cases of miliary pulmonary tuberculosis (5.2%). Twenty-six patients were misdiagnosed in the first diagnosis, with the first misdiagnosis rate of 44.8%, including 15 cases of lung cancer. Conclusion The main cause of misdiagnosis is over-dependence on radiological signs. Comprehensive analysis of diagnostic signs and dynamic observation of lesions could help improve the rate of diagnosis of atypical tuberculosis.