EURORAD ESR

Case 14163

Female genital tuberculosis

Author(s)
Tonolini Massimo, MD; Bonzini Miriam, MD.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
female, 58 year(s)
 
 
  • Figure 1
    Initial contrast-enhanced multidetector CT (abdomino-pelvic images)
     

    Multiplanar post-contrast images showed bilateral adnexal enlargement (+) with hypoattenuating (20-24 Hounsfield units, HU) content and uniform peripheral enhancement. No ascites and adenopathies were present.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Bilateral adnexal enlargement (+) with hypoattenuating (20-24 HU) content and peripheral enhancement. Dilated uterine cavity (*) by similar hypoattenuating content with thin endometrial enhancement (thin arrows).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Dilated uterine cavity (*) by similar hypoattenuating content with thin endometrial enhancement (thin arrows).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Additionally, omental hazy infiltrate (arrowhead) was present. Note thin endometrial enhancement (thin arrows), 4 cm right-sided adnexal enlargement (+) with hypoattenuating (20-24 HU) content and peripheral enhancement.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Additionally, moderate omental hazy infiltrate (arrowheads) was present.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 2
    Initial contrast-enhanced multidetector CT (thoracic images)
     

    In both upper lobes, scattered infracentimetric non-cavitated nodules were present, best appreciated with maximum-intensity projection (MIP) reconstruction (b).

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    In both upper lobes, scattered infracentimetric non-cavitated nodules were present, best appreciated with maximum-intensity projection (MIP) reconstruction (b).

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Additionally, a sizeable (3 cm) partially necrotic mediastinal adenopathy (thick arrow) was present. No pleural and pericardial abnormalities.

     
    Area of Interest: Mediastinum; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Additionally, a sizeable (3 cm) partially necrotic mediastinal adenopathy (thick arrow) was present. No pleural and pericardial abnormalities.

     
    Area of Interest: Mediastinum; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 3
    Follow-up (1 month) contrast-enhanced multidetector CT (abdomino-pelvic images)
     

    Multiplanar post-contrast images showed decreased uterine dilatation (*) compared to Fig.1 with persistent endometrial enhancement (thin arrow), unchanged adnexal lesions (+) and omental infiltration (thick arrow).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Multiplanar post-contrast images showed decreased uterine dilatation (*) compared to Fig.1 with persistent endometrial enhancement (thin arrow), unchanged adnexal lesions (+).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Multiplanar post-contrast images showed unchanged adnexal lesions (+) and omental infiltration (thick arrow).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 4
    Follow-up (1 month) contrast-enhanced multidetector CT (thoracic images)
     

    Repeated CT including MIP reconstuction (b) showed minimal size decrease of some of the non-cavitated nodules scattered in both upper lung lobes.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Repeated CT including MIP reconstuction (b) showed minimal size decrease of some of the non-cavitated nodules scattered in both upper lung lobes.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    The solitary mediastinal adenopathy (thick arrow) showed stable size and persistent necrosis.

     
    Area of Interest: Mediastinum; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
Multiplanar post-contrast images showed bilateral adnexal enlargement (+) with hypoattenuating (20-24 Hounsfield units, HU) content and uniform peripheral enhancement. No ascites and adenopathies were present.
 
Bilateral adnexal enlargement (+) with hypoattenuating (20-24 HU) content and peripheral enhancement. Dilated uterine cavity (*) by similar hypoattenuating content with thin endometrial enhancement (thin arrows).
 
Dilated uterine cavity (*) by similar hypoattenuating content with thin endometrial enhancement (thin arrows).
 
Additionally, omental hazy infiltrate (arrowhead) was present. Note thin endometrial enhancement (thin arrows), 4 cm right-sided adnexal enlargement (+) with hypoattenuating (20-24 HU) content and peripheral enhancement.
 
Additionally, moderate omental hazy infiltrate (arrowheads) was present.
 
In both upper lobes, scattered infracentimetric non-cavitated nodules were present, best appreciated with maximum-intensity projection (MIP) reconstruction (b).
 
In both upper lobes, scattered infracentimetric non-cavitated nodules were present, best appreciated with maximum-intensity projection (MIP) reconstruction (b).
 
Additionally, a sizeable (3 cm) partially necrotic mediastinal adenopathy (thick arrow) was present. No pleural and pericardial abnormalities.
 
Additionally, a sizeable (3 cm) partially necrotic mediastinal adenopathy (thick arrow) was present. No pleural and pericardial abnormalities.
 
Multiplanar post-contrast images showed decreased uterine dilatation (*) compared to Fig.1 with persistent endometrial enhancement (thin arrow), unchanged adnexal lesions (+) and omental infiltration (thick arrow).
 
Multiplanar post-contrast images showed decreased uterine dilatation (*) compared to Fig.1 with persistent endometrial enhancement (thin arrow), unchanged adnexal lesions (+).
 
Multiplanar post-contrast images showed unchanged adnexal lesions (+) and omental infiltration (thick arrow).
 
Repeated CT including MIP reconstuction (b) showed minimal size decrease of some of the non-cavitated nodules scattered in both upper lung lobes.
 
Repeated CT including MIP reconstuction (b) showed minimal size decrease of some of the non-cavitated nodules scattered in both upper lung lobes.
 
The solitary mediastinal adenopathy (thick arrow) showed stable size and persistent necrosis.
 
 
 
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