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Tuberculosis

Densities in Left Lower Lobe

08/06/2010

Question:

I`m 26 yrs old. We do annual check-up in our company. Last year when I got my x-ray result it was CLEAR. But this year annual check-up I was surprised that I had a recommendation to see a pulmonologist because there are suspicious densities in my left lower lobe. But since then I never had the chance to see a pulmonologist. My question is, do I have a TB? I could not remember coughing on the entire year up to this time. We had also no TB history in the family. I do not feel any strange or sick feeling in my chest. Please help me understand. What could that be? Thanks so much!

Answer:

It is very difficult to know what the reasons for the abnormality on the x-ray may be due to. There are many causes that may or may not be related to TB. It is best to make an appointment to see the pulmonologist as soon as possible.

It is good that currently you do not have any signs or symptoms of active TB and no known contacts with anyone with active TB disease. But since the cause of the x-ray is unknown, a detailed evaluation is needed. The pulmonologist may order a computer tomography (CT) scan of the chest to better look at the area of abnormality or do a bronchosocopy to look at the area of the lung that is abnormal.

In the United States, the Centers for Disease Control and Prevention usually does not recommend annual CXR as a screening method for tuberculosis (TB). Have you had a tuberculin skin test or an interferon gamma release assay (TB blood test)? Both of these tests are approved for screening of latent TB infection (patients with a history of TB exposure and infection but no evidence of active TB disease). Even though these tests cannot rule out active TB disease, it may be helpful to perform them as part of the evaluation process. The pulmonologist will be able to go over all of the tests necessary for evaluation of your abnormal x-ray.

For more information:

Go to the Tuberculosis health topic, where you can:

Response by:

Shu-Hua   Wang, MD, MPH&TM Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University

Larry S Schlesinger, MD Larry S Schlesinger, MD
Professor:
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University