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Is 'right basal discrete nodule and left basal fibrosis' indication of TB?

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Internal Medicine Specialist
Practicing since : 2009
Answered : 2752 Questions
i had chest xray done two months ago and this is the result right basal discrete nodule and left basal fibrosis; my doctor is thinking whether this could be related to TB, in your opinion what could be the possible problem? my doctor also asked me to undergo afb smear and sputum culture, all 3 smears are negative now Im waiting for the final sputum culture result do you thik my culture will also be negative. I dont have any syptoms that can be attibuted to TB..
Posted Sun, 2 Feb 2014 in Lung and Chest disorders
Answered by Dr. Anshul Varshney 35 minutes later
Brief Answer: Detail Follows Detailed Answer: Dear Friend Thanks for sharing your problem with us. This kind of Nodule with fibrosis can be due to following reasons: 1. Pulmonary Tuberculosis 2. Malignancy 3. Benign nodules like Hamartomas. 4. A part of interstitial lung disease (ILD) like sarcoidosis. Usually ILD has multiple reticulo nodular opacities. Sarcoidosis has bilateral hilar adenopathy. Malignancy is usually associated with weight loss, haemoptysis. If you have fever, cough with expectoration, weight loss, chances of TB are more. In fact presence of fibrosis goes in favour of TB that had healed in that area. I advice you following investigations : 1. Hemogram with ESR 2. Sputum for AFB under DOTS (if you are in india) 3. Montoux Test. (Not a specific test but helps in differentiating TB and Sarcoidosis) 4. Contrast enhanced CT Chest. After these investigations I am sure your diagnosis will be clear. Even if diagnosis won't get clear, a broncoscopy can be done. I am not saying you have all these problems, I have just kept possibilities in front of you. I hope I am able to solve your query , still if you have any query ask me.
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Follow-up: Is 'right basal discrete nodule and left basal fibrosis' indication of TB? 2 hours later
my afb smears are negative im waiting for the culture result i dont have sypmtoms except from this incidental findings on routine us immgrant physical exam so you think the culture will also be negative?
Answered by Dr. Anshul Varshney 5 hours later
Brief Answer: CECT Chest Detailed Answer: Hi, As such there is no importance of sputum culture for mycobacteria , if sputum for AFB done from a reliable lab. At present you should get the investigations I suggested especially CECT Chest , which will clear most of the picture. Good Luck. If you don't have any further query , you may please close the discussion and rate it.
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