Shahid Beheshti University of Medical Science
Radiology Professor Assistant, Department of Radiology, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Recognition of imaging findings in disseminated bacilli Calmette-Guerin disease in immunodeficient patients is important for prompt diagnosis and treatment and reduction of the burden of problem. The purpose in this study was to determine the CT scan findings in BCGosis in primary immunodeficiency patients.
Methods and Materials:
In this observational cross-sectional comparative study, 22 consecutive patients with immunodeficiency in Masih-Daneshvari Hospital, Tehran, Iran with disseminated bacilli Calmette-Guerin disease were enrolled and the CT scan findings were determined in them.
Mediastinal soft tissue mass, parenchymal soft tissue lesions, soft tissue lesions with fusion, soft tissue lesions with lobulation invasion to mediastinal structures, chest wall, ribs, collapse, and tract were present in 54.5%, 36.4%, 36.4%, 9.1%, 36.4%,27.3%, 18.2%, 31.8%, and 9.1%, respectively. Subcutaneous abscess, phrenic invasion, pleural effusion, thickening, extra pleural fat were seen in 9.1%, 9.1%, 27.3%, 22.7%, and 9.1% respectively. Axillary, hillar, mediastinal, prediaphragmatic, retrocrural, upper abdominal, and cervical LAP were seen in 54.5%, 36.4%, 50%, 22.7%, 18.2%, 59.1%,
and 27.3%,respectively. No milliary lesion was seen. Tree-in-budd, nodule, cavity, consolidation, GGO, collapse, bronchiectasis,and scar were seen in 4.5%, 18.2%, 9.1%, 31.8%, 13.6%, 31.8%, 22.7%,
and 4.5%, respectively. Splenomegaly,hypoecho lesions of spleen, spleen mass, hepatomegaly, and liver mass were seen in 59.1%, 13.6%, 9.1%, 27.3%, and 4.5%, respectively. Femoral, retropritoneal, and mesenteric LAP were present in 22.7%, 13.6%, and 50%, respectively.
bowel Wall thickening, ascitis, omental cake, dirty mesentry, and abcess were present in 40.9%, 22.7%, 4.5%, 27.3%, and 22.7%, respectively. Conclusion: CT scan findings in disseminated bacilli Calmette-Guerin disease in patients with primary immunodeficiency are multiple and diverse. Use of combination of them in the proper clinical context would be useful to predict the presence of disease, or to raise a suspicion of underlying immunodeficiency in patients without positive history of such condition and the mediastinal mass plus lymphadenopathy and organomegaly are good indicators in highly suspected patients.