Comparative analysis of Airway Invasive Aspergillosis and Endobronchial spread of Tuberculosis on High Resolution Computed Tomography
Keywords:
High-resolution Computed Tomography, Endobronchial Tuberculosis, Airway-Invasive AspergillosisAbstract
Background: Distinction between airway-invasive aspergillosis (AIA) and endobronchial tuberculosis (EBTB) by high-resolution computed tomography (HRCT) continues to be a diagnostic challenge, especially in TB-endemic areas with high immunosuppression rates. Objective: To compare the high-resolution computed tomography (HRCT) imaging features, lesion distribution, and morphologic characteristics of airway-invasive aspergillosis (AIA) and endobronchial tuberculosis (EBTB) to improve diagnostic accuracy.Methodology: Retrospective comparative study was conducted form January 2022 to February 2023 among 63 patients (30 with AIA and 33 with EBTB) on the basis of clinical, microbiological, and radiological evidence. HRCT results were evaluated by senior radiologists for definite patterns such as centrilobular nodules, tree-in-bud appearance, ground-glass opacities, halo sign, cavitation, and lymphadenopathy. Results: Although both diseases exhibited tree-in-bud and centrilobular nodules, EBTB was typified by dense, clustered nodules with upper lobe predominance and extensive cavitation. AIA exhibited ground-glass nodules with fuzzy borders, lower lobe prevalence, and common halo sign. Morphologic distinctions among nodules and lesion distribution were statistically significant.Conclusion: HRCT is useful to differentiate AIA from EBTB in the clinical context. Identification of these characteristic patterns may direct proper therapy, enhance outcomes for patients, and decrease diagnostic delay in situations when these infections are present.References
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