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PATOLOGIEPATOLOGIEPULMONARAPULMONARA

DIAGNOSTIC RADIOLOGIC /IMAGISTIC

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Patologie bronsicaPatologie bronsica• I.I.DISPLAZII CHISTICEDISPLAZII CHISTICE• II.B.P.O.C.II.B.P.O.C.

• III.BRONSIECTAZIIIII.BRONSIECTAZII• IV.BRONHOCELIV.BRONHOCEL• V.MUCOVISCIDOZAV.MUCOVISCIDOZA

• VI.CORPI STRAINI TRAHEO-BRONSICIVI.CORPI STRAINI TRAHEO-BRONSICI• VII.CANCER BRONHO-PULMONAR VII.CANCER BRONHO-PULMONAR

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I.Displazii chisticeI.Displazii chisticeDefinitie: malformatii congenitale ale mugurelui bronsicterminal (bronsiolar).

CHISTUL SOLITARPOLICHISTOZA: segmentara, lobara, pulmonara

Descriere radiologica:

- hipertransparenta rotund o!alara" perete #in"

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CHISTURI AERIENE :tipul SOLITAR CHISTURI AERIENE :tipul SOLITAR

Patologie bronsica

Tomogr !ii pl "#Tomogr !ii pl "#

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CHISTURI AERIENECHISTURI AERIENE MULTIPLEMULTIPLE

Pl mi" poli$%i&ti$Pl mi" poli$%i&ti$

Bo l gm#"t rBo l gm#"t r

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CHISTURICHISTURI

AERIENE:AERIENE:MULTIPLE'MULTIPLE'

ABCEDATEABCEDATE

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II.B.P.O.C.II.B.P.O.C.(.BRONSITA CRONICA: R).&t "* r*: -*#" pulm.%ilio-+ , l i"t rit

.EM/IZEM PULMONAR: Distensie; - hipertransparenta (ruptura pereti alveolari sidistrugerea patului capilar).

=>Afectarea bronsiilor mici

0.ASTM BRONSIC INTRICAT: I"!l m ti# p ri#t l *opuri *# mu$u& +ul# *# #m!i,#m *# $om+i" ti# $u ( &i .

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EMFIZEM PULMON !

Emfzem: hipertransparenta a campurilor pulmonare, multiple bule deemfzem/zone avasculare, artere pulmonare proeminente, cresterea

diametrului AP, dia ragm aplatizat.

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Emfi"emul #ulmonar

Emfizem centrilobular – ariiconfluente de distructie aparenchimului pulmonar

Voluminoasa bula de emfizem inLSD ce impinge mediastinul sicomprima bronhia lobara.

A B

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Bronsita cronica: opacitati lineare neregulat delimitatedispuse de-a lungul vaselor pulmonare peri si infrahilar

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Bronsita cronica: opacitati lineare neregulat delimitatedispuse de-a lungul vaselor pulmonare peri si infrahilar

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BRONSITA CRONICA:BRONSITA CRONICA: +ro"%ogr !ii+ro"%ogr !ii

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BRONSITA DE/ORMANTABRONSITA DE/ORMANTA

P tologi# +ro"&i$P tologi# +ro"&i$ULCERATII

1NISE2 PARIETALE

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III.BRONSIECTAZIIIII.BRONSIECTAZII 3 *il t ri +ro"&i$#3 *il t ri +ro"&i$#

A$%CO&'(&ITAL(: in sd.malformative comple e:

$%.& !' ENE!: situs in*ersus+ etmoi%o antrita(sur%itate) bronsiecta"iic,istice $%.MEUNIE! &- N: i%em+ fara situs in*ersus.

B).B). DOBINDITEDOBINDITE :: dupa BPOC sau sec. altor a ectiuni (tractiuni parietale externe- KK, fibroza, etc)

Rx.standard:

- im gi"i $%i&ti$# 4" $ p5tul u"or li"ii $l r# 6 ro,#t Am#uill#7ro,#t Am#uill#7- Im gi"i $u &p#$t i" ! gur# & u l#m" m4"$ t *# $ rii- Im gi"i $u &p#$t i" ! gur# & u l#m" m4"$ t *# $ rii 6$8"* +ro"%i #&t# go l57 9i*# op $it5 i li"i r# t#rmi" t# 4" 1*#g#t *# m5"u952 6$8"* +ro"%i #&t# pli"57 ; ;r# li, "* &p#$t *# 2$ior$%i"#2 & u $or*o "# #t$r# li, "* &p#$t *# 2$ior$%i"#2 & u $or*o "# #t$ -- +ro"&i#$t ti$ %ilio-+ , l +ro"&i#$t ti$ %ilio-+ , l

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/ronsiecta"ii congenitale

Bronsiectazii bibazale si dextrocardie

sindrom !artagener

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BRONSIECTAZII BILATERALE:&upr i"!#$ti# $uti, tBRONSIECTAZII BILATERALE:&upr i"!#$ti# $uti, t

Triu"g%iul +ro"&i#$t ti$Triu"g%iul +ro"&i#$t ti$

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BRONSIECTAZII: 1ROZETA AMEUILLE2BRONSIECTAZII: 1ROZETA AMEUILLE2

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BRONSIECTAZIIBRONSIECTAZII BRONSII NORMALEBRONSII NORMALE

BRONHO

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/ronsiecta"iile

Bronsiectazii chistice – !" #g $! - imagini transparente liniare si rotun%itelocalizate in ambele regiuni infrahilareB" &' ()mm" bronsiectazii chistice (cu nivel *!" si ingrosari pleurale bilaterale

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/ronsiecta"iile

Bronsiectazii cilindriceSageata – artera+bronhie dilatata , semnul inelului cu pecete

!tentie la diametrul bronhiei / cel al arterei insotitoare

) mm 012 mm

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R *iogr !i# &t "* r*R *iogr !i# &t "* r* Bro"%ogr !i#Bro"%ogr !i#

CANCER BRONHO-PULMONAR LOB SUPERIORCANCER BRONHO-PULMONAR LOB SUPERIORDREPT 6tip #"*o+ro"&i$:o+&tru$ti# +ro"&i$ &i t#l#$t ,i#DREPT 6tip #"*o+ro"&i$:o+&tru$ti# +ro"&i$ &i t#l#$t ,i#$u"* r 7$u"* r 7

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CANCER ENDOBRONSICCANCER ENDOBRONSIC

O+&tru$ti +ro"&i#i primiti=#:ATELECTAZIE TOTALAO+&tru$ti +ro"&i#i primiti=#:ATELECTAZIE TOTALA

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CANCER E>OBRONSIC-CANCER E>OBRONSIC-

11MASIV AL HILULUI2MASIV AL HILULUI2

“Krebs füsse”

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CANCER NODULAR PERI/ERICCANCER NODULAR PERI/ERIC

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CANCERCANCER

NODULAR NODULAR

PERI/ERICPERI/ERIC

Comput#r tomogr !i#:Com put#r tomogr !i#:

A7.!#r# &tr pulmo"A7.!#r# &tr pulmo"

B7.!#r# &tr m#*i &ti"B7.!#r# &tr m#*i &ti"

AA

BB

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"g# masa neregulatdelimitata parahilara dreapta$

C%# leziune solida localizataapico&dorsal dreapta siadenopatie mediastinala.

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ROLUL E .ROLUL E .

IMAGISTICEIMAGISTICE

(7(7EVIDENTIAZA TUMORAEVIDENTIAZA TUMORA :-:- R).&t "* r*'+ro"%ogr !i 'CT.R).&t "* r*'+ro"%ogr !i 'CT.

Aspecte Aspecte :: --cancercancerhilar(central)endobronsic=>hilar(central)endobronsic=> atelectazieatelectazie

6gm#"t'lo+'pulmo"76gm#"t'lo+'pulmo"7 emfzem sistemfzem sist ..66r rr r 77 bron"ografiebron"ografie :: sten.sten. amp tatii (!TO")#amp tatii (!TO")# dg.dif.:pneumonie;dg.dif.:pneumonie;

$cancer hilar (central)e%obronsic=>$cancer hilar (central)e%obronsic=> nod lnod l

opacopachilar & prel n'iri radiare=hilar & prel n'iri radiare= rebs *+sse,(picioarerebs *+sse,(picioarecrab)crab)*g.*i!.: *#"op ti#' "#=ri&m .pulm.*g.*i!.: *#"op ti#' "#=ri&m .pulm.

$cancer peri*eric-nod lar=>$cancer peri*eric-nod lar=> nod l opacnod l opac'r.II$'r.II$III-cont r nere' lat (prel n'iri..)-intensitateIII-cont r nere' lat (prel n'iri..)-intensitatemare#mare#* .*i!.:$%i&t %i* ti$ tu+#r$ulom % m rtom.* .*i!.:$%i&t %i* ti$ tu+#r$ulom % m rtom.

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CANCER E>TINS LOBAR CANCER E>TINS LOBAR

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3odul tumoral de 014cm neregulat delimitatsituat LSD ('0"5

Sectiune caudalademonstreazaadenopatie pretraheala(3)"5

&ancer e cavatin LSD

!denopatielaterotrahealadreapta6etastazehepatice('3)60"

A B

C C

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"g# opacitate apicala

stanga.

C% # masa apico&

dorsala ceinvadeaza pereteletoracic adiacent.

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CANC*R +'LMONAR M*TASTATIC CANC*R +'LMONAR M*TASTATIC CAI .( PRO/(&I(&TA:CAI .( PRO/(&I(&TA:

00

$$

(*MATOG*NA(*MATOG*NA

1212

no uli opaci !r.II-III, ise"inatino uli opaci !r.II-III, ise"inati

anar#ic, bilateral, ine!ali$ nu confluiaza$ contur net, for"a rotun aanar#ic, bilateral, ine!ali$ nu confluiaza$ contur net, for"a rotun a(“lansare e baloane”..).(“lansare e baloane”..). Cauta:Cauta: cancer cancer

primitiv teritoriul cav: sin testicul rinichi os prostata... primitiv teritoriul cav: sin testicul rinichi os prostata...

3$3$ LI45ATICALI45ATICA 1212 Limfangio aLimfan gio a : -: - diseminare peribonho-diseminare peribonho-vasculara!interstitiala parenchimatoasa: cordoane micronodulivasculara!interstitiala parenchimatoasa: cordoane micronoduli perihilar!hilioba"al bilat.;asociere cu pleure"ie. perihilar!hilioba"al bilat.;asociere cu pleure"ie.CautaCauta %% sansan ,, pancreas,sto"ac,etc. pancreas,sto"ac,etc.

)) /I0T1:$carcinomatoza miliara,:/I0T1:$carcinomatoza miliara,: - ise"inare ininterstitiu,li"fatice"ato!en% micronoduli diseminati pe fond trabecular bilateral;tendinta la conglomerare.&auta:&auta: sin1 tiroida1digestivsin1 tiroida1digestiv

.g%di# . g%di# %:%: bronhopneumonie,hidatido6a, miliara tb+,bronhopneumonie,hidatido6a, miliara tb+, sili+o6a, !iro6e, +olageno6esili+o6a, !iro6e, +olageno6e

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METASTAZE PULMONARE TIP HEMATO

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METASTAZE PULMONARE TIP LIM/ATICMETASTAZE PULMONARE TIP LIM/ATIC

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Limfangio"a carcinomatoasa

8pacitati liniare interstitiale simicronoduli diseminati bilateral caurmare a unei diseminarihematogene

Diseminare locala de la uncancer bronhiolo-alveolar –ingrosare neregulata nodularaa interstitiului perilezional

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PNEUMOPATIIPNEUMOPATIIIN!LAMATORIIIN!LAMATORII

I.I. 123TE123TE :: $$ BACTERIENE"BACTERIENE"

- BACTERIENE SUPURATIVE#- BACTERIENE SUPURATIVE#

- VIRALE $%ATIPICE&'#- VIRALE $%ATIPICE&'#

IIII .24ONI2E.24ONI2E :: $ T3BE4235O61#$ T3BE4235O61#

$ 1lte boli c componenta$ 1lte boli c componenta

in7amat.in7amat.

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I$+N*'MONII MICRO,I*N* I$+N*'MONII MICRO,I*N*

$$franca lo.ara $$$franca lo.ara $ *tiologie *tiol ogie :-infectia cu pneumococ$streptococ$etc.:-infectia cu pneumococ$streptococ$etc.

+istoppatologie:- +ist oppatologie:- sd.sd. de umplere alveolara=>,- faze:de umplere alveolara=>,- faze:

Anatomie radiol Anatomie radiol .:=> .:=> --$o"g#&ti#$o" g#&ti#==& A/;( & A/;( debut)debut)- tes.fibrino-"em0=>- tes.fibrino-"em0=> --%#p ti, ti#%#p ti, ti# =>=> 1/ ' P2*3# 24' 1/ ' P2*3# 24'

( ( stare) =>stare) => opac$segmente$lobi; opac$segmente$lobi;-retur anat.patol. =>-retur anat.patol. => --r#,or+ti#r#,or+ti# :-:- omogenaomogena =atenuare sincrona=atenuare sincrona -neomogena-neomogena = tabla sa"!;= tabla sa"!; -centru-centru =>periferie;=>periferie; -- periferie periferie =>centru=>centru'omplicatii 'om plicatii :-:- pleurezii-para%meta-pneumonice pleurezii-para%meta-pneumonice

-abces secundar.-abces secundar.

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PNEUMONIE BACTERIANA LOB MEDIUPNEUMONIE BACTERIANA LOB MEDIULATERALLATERAL

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PNEUMONIE BACTERIANA LOB MEDIUPNEUMONIE BACTERIANA LOB MEDIU

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PNEUMONIE BACTERIANA LOB SUPERIOR PNEUMONIE BACTERIANA LOB SUPERIOR

S#gm#"t )il rS#gm#"t )il r

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PNEUMONIE BACTERIANA PLURISE

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/OCARE PNEUMONICE/OCARE PNEUMONICE MULTIPLEMULTIPLE

/O LER /O LER

LIN

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PNEUMONIE BACTERIANA:PNEUMONIE BACTERIANA: *i g"o&ti$ *i!#r#"ti l*i g"o&ti$ *i!#r#"ti l

P"#umo"i# + $t#ri "P"#umo"i# + $t#ri " At#l#$t ,i#:$ "$#r #"*o+ro"&i$At#l#$t ,i#:$ "$#r #"*o+ro"&i$

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PNEUMONIE BACTERIANA ACUTAPNEUMONIE BACTERIANA ACUTA

BRONHO

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Pneumonia bacteriana

!rie nespecifica de consolidarecu bronhograma aerica

Dg dif empiem 9 abces

Empiem multiloculat !bces

A B

C '

Tip ITip I

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REZORBTIAREZORBTIAPNEUMONIEIPNEUMONIEI

AA

B

pp

Tip IIITip III

Tip IITip II

II BRON(OPNEUMONIII BRON(OPNEUMONI

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II.BRON(OPNEUMONIII.BRON(OPNEUMONI A A

*tiologie *tiol ogie :streptococ$pneumococ$5riedlander$..colibacil etc.:streptococ$pneumococ$5riedlander$..colibacil etc.5recventa ma 5recventa ma :-:- nou nascut$batrin$imunodeficienta (S46A);nou nascut$batrin$imunodeficienta (S46A);

+istopatologie +ist opatologie :: -nodulul bron"iolo-alveolar:-nodulul bron"iolo-alveolar: -mici (acin);-mici (acin); -mari (lobul);-mari (lobul);

Aspecte radiologice As pecte radiologice :: -gr * I-II *imi" r# +il t. &im#tri$-gr * I-II *imi" r# +il t. &im#tri$ -r#&p#$t + ,#l# &i p#)ul-r#&p#$t + ,#l# &i p#)ul -$o"tur !luu 6$o"g#&ti#7-$o"tur !luu 6$o"g#&ti#7 -$#"tru op $ 6+ro"&iol o+&tru t 7-$#"tru op $ 6+ro"&iol o+&tru t 7 -$o"!lui , 3 pu*olo+ r-$o"!lui , 3 pu*olo+ r - &i"$ro"i&m #=oluti=- &i"$ro"i&m #=oluti= - &o$i , #m!i,#m +ulo&'tr =## op $#- &o$i , #m!i,#m +ulo&'tr =## op $#5orme specifice5orme s pecifice :: -tbc-tbc :evol.subacuta$noduli e cavati=caverne:evol.subacuta$noduli e cavati=caverne --stafilococicastafilococica :-pneumatocele$complicatii :-pneumatocele$complicatii

supurative (piotora $abcese multiple);gravitate ma7ora 8supurative (piotora $abcese multiple);gravitate ma7ora 8

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BRONHOPNEUMONIEBRONHOPNEUMONIE

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BRONHOPNEUMONIEBRONHOPNEUMONIE

/ORMA PSEUDOLOBARA/ORMA PSEUDOLOBARA

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+ne"mo)atii ac"te s")"rate+ne"mo)atii ac"te s")"rate1B2E!351B2E!35

"35/ON14"35/ON14

#ec.patogenic: #ec .patogenic: -bron"ogen(aerogen..abcedarea pneumoniei);-bron"ogen(aerogen..abcedarea pneumoniei); -"ematogen(septico-pioemie);-"ematogen(septico-pioemie); -contiguitate(plagi$fracturi$post-operator);-contiguitate(plagi$fracturi$post-operator);

*tiologie: -amoe.ian0stafilo0stre)to0&riedlander0etc$

1nat$radiol1nat$radiol .:.: $a)stadi pre$s p rati8$a)stadi pre$s p rati8 (pre-(pre-vomica):blocvomica):bloc

pneumonic atipic$!amputat!;opacit. centrala pneumonic atipic$!amputat!;opacit. centralaintensa$nodulara;intensa$nodulara;b)stadi s p rati8b)stadi s p rati8 66 post-vomica) post-vomica) -recent:!gura de-recent:!gura decuptor!:cuptor!:imagine "idro-aerica$nivel inalt$liniar$neted;congestie in 7ur;imagine "idro-aerica$nivel inalt$liniar$neted;congestie in 7ur;-vec"i=>cronicizare (sapt):nivel lic"id.9 congestia-vec"i=>cronicizare (sapt):nivel lic"id.9 congestia inel opacinel opac

periferic$gros(membrana piogena)$cavitate ne-elastica. periferic$gros(membrana piogena)$cavitate ne-elastica.2)stadi l complicatiilor:2)stadi l complicatiilor: -piotor ) pio-p"#umotor ).-piotor ) pio-p"#umotor ).E)*l+tieE)*l+tie "-)i, eca e sechele /0 *ase"-)i, eca e #sechele /0 *ase#

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ABCES PULMONAR:! ,ABCES PULMONAR:! ,

pr#-=omi$pr#-=omi$

ABCES PULMONAR:! ,ABCES PULMONAR:! ,

pr#-=omi$pr#-=omi$

ABCES PULMONARABCES PULMONAR

SECUNDAR SECUNDAR

ABCES PULMONARABCES PULMONAR

SECUNDAR SECUNDAR

Ni=#l %i*ro #ri$Ni=#l %i*ro #ri$

p"#umo"i#

pl#ur#,i#pl#ur#,i#

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ABCES PULMONAR SECUNDAR PNEUMONIEIABCES PULMONAR SECUNDAR PNEUMONIEI

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ABCESABCESPULMONAR PULMONAR

IN /AZAIN /AZACRONICACRONICA

11CHIRUR

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P&(U4OPATII ACUT(P&(U4OPATII ACUT(&(7ACT(RI(&(&(7ACT(RI(&(

P2*3# 244 42 * S 4 4A/*$A 4P4'* P2*3# 244 42 * S 4 4A/*$A 4P4'* *tiologie *tiolo gie :-=iru&uri::-=iru&uri: -i"!lu#", #6grip ?7'p r grip l#' *#"o=iru&'r#&pir t.-i"!lu#", #6grip ?7'p r grip l#' *#"o=iru&'r#&pir t.&i"$iti l''m )o=iru&'m $opl &m p"#umo"i # 6 g.EATON7'=.ru #oli$'&i"$iti l''m )o=iru&'m $opl &m p"#umo"i # 6 g.EATON7'=.ru #oli$'+ $il p#rtu&i& 6tu $o"=ul&i= 7'Ri$F#t&i Bur"#tti'or"ito, 'p&itt $o, G+ $il p#rtu&i& 6tu $o"=ul&i= 7'Ri$F#t&i Bur"#tti'or"ito, 'p&itt $o, G

Mec$)atogenic:Mec$ )atogenic: - - inf$aerogena )ic$&l1ge 23.ronsiolita!inf$aerogena )ic$&l1ge 23.ronsiolita!infiltr$)arietala .r$0)eri.ron4ovasc"lar!limfangita!infiltr$)arietala .r$0)eri.ron4ovasc"lar!limfangita!edem .ronsiolar0o.str"ctie .r$!mec$s")a)a!atelecta ii edem .ronsiolar0o.str"ctie .r$!mec$s")a)a!atelecta ii acinare!."le de emfi em$acinare!."le de emfi em$

Aspecte Rx Aspecte Rx :-:- i"!iltr t %ilio+ , l:i"!iltr t %ilio+ , l: grip l Dittm r Rup#rtgrip l Dittm r Rup#rt

-2 ripi !lutur#2p#ri%il r -r#ti$ulogr "it t'"o*uli mili ri-2 ripi !lutur#2p#ri%il r -r#ti$ulogr "it t'"o*uli mili ri$i" ri6 t#l#$,ii $i" r#7 +ul# #m!i,#m.$i" ri6 t#l#$,ii $i" r#7 +ul# #m!i,#m.

2omplicatii2om plicatii :$:$bronhopne monie-pne monie-ple reziibronhopne monie-pne monie-ple reziimici.mici.

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PNEUMONIE INTERSTITIALA:

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INTERSTITIALEINTERSTITIALE

RUJEOLARUJEOLA

TUSE CONVULSIVATUSE CONVULSIVA

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PNEUMOPATIIPNEUMOPATIIACUTEACUTEINTERSTITIALE:INTERSTITIALE:

COMPLICATIICOMPLICATII

PNEUMOPATIIPNEUMOPATIIACUTEACUTEINTERSTITIALE:INTERSTITIALE:

COMPLICATIICOMPLICATII

B *+ * / *I

PNEUMONIEPNEUMONIESE

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• Tu+#r$ulo, prim r5 0 for"e e "anifestare ra iolo!ic1%• $ompl#)ul prim r 0 cu trei ele"ente istincte% afectul pri"ar, li"fan!it1 2i

a enopatie$ e3ol 456 buna 7 856 co"plicatii$• afectul pri"ar este un focar e al3eolit1 exu ati31, e for"1 rotun 1 sau

nere!ulat poli!onal1, cu i"ensiuni 3ariate, e la 8 "" p9n1 la i"ensiunileunui se!"ent sau c#iar peste, situat e obicei la baza lobilor, cu pre o"inen:1 alobului inferior.

• li"fan!ita tuberculoas1 se prezint1 sub for"a unor benzi opace #ilipete cucontur 2ters, e intensitate "ic1, cu no uli "iliari ;n2ira:i e-a lun!ul lor.

• a enopatia satelit1 realizeaz1 o opacitate rotun 1 sau o3alar1 cu i"ensiuni3ariate ("" 0 c"), uni sau bilateral1, e intensitate "e iastinal1 2i contur net,uneori policiclic.

• co"plicatiile co"plexului pri"ar% complica#ii bronhice ( fistula a eno- bron#ic1$ atelectazia$ #iperinfla:ia)$ complica#ii pleurale ( pleurezie purulent1),complica#ii pulmonare ( con ens1ri infla"atorii necazeificante - substrat

exu ati3 e cauz1 aler!ic1, apar rapi , e3oueaz1 f1r1 o clinic1 e3i ent1, isparrepe e, c#iar f1r1 "e ica:ie -, con ens1ri infla"atorii cazeificante -pneu"oniacazeoas1 cu structur1 neo"o!en1, ;n “"iez e p9ine”, atorit1 ulcera:iilor cuten in:1 la extin ere 2i confluare -, ca3erna pri"ar1.

• *#"op ti# %il r5 0 f1r1 "o ific1ri ra iolo!ice pul"onare$• pl#ur#,i# ro!i+ri"o &5 u"il t#r l5• tu+#r$ulo, prim r5 mili r5 0 cu ten in:a e ocupare a c9"purilor pul"onare

superioare.

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COMPLE> PRIMAR TUBERCULOSCOMPLE> PRIMAR TUBERCULOS

A/ECTA/ECT

LIM/AN

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COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT:

$o"g#&ti# p#ri!o$ l$o"g#&ti# p#ri!o$ l

COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT: $o"g#&ti# p#ri!o$ l$o"g#&ti# p#ri!o$ l

Tuber+ulo6a primara

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"g# zona de condensare '((.)oua granuloame calci cate parahilar stanga si bazal stanga*ara adenopatie.

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COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT: p#ri *#"itp#ri *#"it

COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT: p#ri *#"itp#ri *#"it

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COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT:3*imi" r# %#m to #" 3 mili r t+$

COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT: *imi" r# %#m tog#" 3 mili r t+$*imi" r# %#m tog#" 3 mili r t+$

ADENITAADENITA

Tuber+ulo6a primara

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"g + C%# iliarie %BC & micronoduli diseminati in ambele campuripulmonare

p

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ADENITAADENITA

COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT: p"#umo"i $ ,#o &p"#umo"i $ ,#o &

COMPLE> PRIMAR TBC COMPLICAT:COMPLE> PRIMAR TBC COMPLICAT:

p"#umo"i $ ,#o &p"#umo"i $ ,#o &

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SECHELE DUPA TBC PRIMARA:SECHELE DUPA TBC PRIMARA:

--NODULI /IBROSINODULI /IBROSI APICALI SIAPICALI SI

SUBCLAVICULARISUBCLAVICULARI

--CALCI/ICARICALCI/ICARI IN PARENCHIM IN PARENCHIM

SI

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T',*RC'LO5A S*C'NDARAT',*RC'LO5A S*C'NDARA

0$%0$%&oduli #ibrosi api+o sub+la!i+ulari:&oduli #ibrosi a pi+o sub+la!i+ulari: )otential fti io- geni ,6 7dormant823reactivare ! R92micronod"li ti)Simon0Asc4off-+"4l0(ed all! reactiv23migrare s$clav$

7.7.I"!iltr tul pr#$o$# &u+$l =i$ul r:I"!iltr tul pr#$o$# &u+$l =i$ul r: 33 l=#olit #)&u* ti=l=#olit #)&u* ti="#=i"*#$ +il &po"t " R)3"#=i"*#$ +il &po"t " R)3 "o*ul p li* gr.II tip A&&m "6ro-"o*ul p li* gr.II tip A&&m "6ro-tu"*7'/l#i&$%"#r6o= l7'R#*#$F#r6p trul t#r7'Du!our6"#+ulo&tu"*7'/l#i&$%"#r6o= l7'R#*#$F#r6p trul t#r7'Du!our6"#+ulo&77

*volutie: necroza

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NODULI /IBROSI APICALI 3 POTENTIAL /TIZIO

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IN/ILTRAT PRECOCE TBC33IN/ILTRAT PRECOCE TBC33

33 DEBUTUL /TIZIEIG..33 DEBUTUL /TIZIEIG..

IN/ILTRAT PRECOCE TBC33IN/ILTRAT PRECOCE TBC33

33 DEBUTUL /TIZIEIG..33 DEBUTUL /TIZIEIG..

$o *$o *

paleta

11r $%#t *# t#"i&2r $%#t *# t#"i&2

I"!iltr t i" $ur& *#I"!iltr t i" $ur& *# #)$ = r##)$ = r#

Zil#..& pt mi"iZil#..& pt mi"i

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DEBUT AL /TIZIEI ADULTULUI3CAVERNA..DEBUT AL /TIZIEI ADULTULUI3CAVERNA..DEBUT AL /TIZIEI ADULTULUI3CAVERNA..DEBUT AL /TIZIEI ADULTULUI3CAVERNA..

TUBERCULOZA CAZEOASA CAVITARATUBERCULOZA CAZEOASA CAVITARATUBERCULOZA CAZEOASA CAVITARATUBERCULOZA CAZEOASA CAVITARATomogr !i# pl "Tomogr !i# pl "

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forme T,C S*C'NDARA2 5TIZIATBC CAZEOASA -CAVITARA:TBC CAZEOASA -CAVITARA: $ =#r" &olit r -&i&t#m#$ =#r" &olit r -&i&t#m#*# $ =#r"# 61mi#, *# p4i"#27 p"#umo"i# $ ,#o & +ro"%o-*# $ =#r"# 61mi#, *# p4i"#27 p"#umo"i# $ ,#o & +ro"%o-p"#umo"i#.p"#umo"i#.TUBERCULOMUL:TUBERCULOMUL: -"o*ul gr.II'i"t#"&'!i+ro $ l$ r3i"!iltr-"o*ul gr.II'i"t#"&'!i+ro $ l$ r3i"!iltr+lo$ t3 pot#"ti l r# $ti= r#.+lo$ t3 pot#"ti l r# $ti= r#.TBC /IBROASA:TBC /IBROASA: -!orm# mi"or# m JORE.-!orm# mi"or# m JORE.TBC HIPERCRONICA:TBC HIPERCRONICA: -$ =#r"# &$l#ro !i+ro, #)t#"--$ =#r"# &$l#ro !i+ro, #)t#"-

&i= p %ipl#urit# +ro"&i#$t ,ii #m!i,#m.&i= p %ipl#urit# +ro"&i#$t ,ii #m!i,#m.

COMPLICATII SECHELE:COMPLICATII SECHELE: -HEMOPTIZIA /IBRO--HEMOPTIZIA /IBRO-TORA> CORD PULMONAR CR. AMILOIDOZA #t$.TORA> CORD PULMONAR CR. AMILOIDOZA #t$.

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/TIZIE: CAVERNA

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TUBERCULOZA E>TENSIVA CAZEOASATUBERCULOZA E>TENSIVA CAZEOASA

-p"#umo"i# $ ,#o & lo+ i"!.-p"#umo"i# $ ,#o & lo+ i"!.

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TUBERCULOZA CAZEOASA CAVITARATUBERCULOZA CAZEOASA CAVITARATUBERCULOZA CAZEOASA CAVITARATUBERCULOZA CAZEOASA CAVITARA

Ca3erne&infiltrate&fibrozaCa3erne&infiltrate&fibroza

Tomogr !i# pl "Tomogr !i# pl "Tomogr !i# pl "Tomogr !i# pl "

Tuber+ulo6a se+undara

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Tuber ulo6a se undara

"g# opacitati reticulo&nodularesubclaviculare stangi si parahilare externedrepte. *ormatiune cavitara subclavicularastanga.C%# confrma caverna si extensia masiva

endobronsica .

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/TIZIE PNEUMONIE CAZEOASA CAVITARA/TIZIE PNEUMONIE CAZEOASA CAVITARA/TIZIE PNEUMONIE CAZEOASA CAVITARA/TIZIE PNEUMONIE CAZEOASA CAVITARA

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/TIZIE:DISEMINARE BRONHOPNEUMONICA/TIZIE:DISEMINARE BRONHOPNEUMONICA

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/TIZIE/TIZIE :DISEMINARE MILIARA IN:DISEMINARE MILIARA IN/TIZIE/TIZIE :DISEMINARE MILIARA IN:DISEMINARE MILIARA IN