case_images: PMC10546250_01
case_images: Chest radiograph of a 12-year-old female, shows bilateral air space opacities with few cystic lucencies in the right perihilar region (black arrow).
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case_images: PMC10546250_01_SAJR-27-2725-g001.jpg
case_images: F0001
case_images: Chest radiography demonstrated ill-defined, bilateral air space opacities, with a few cystic lucencies in the right perihilar region (Figure 1).
case_images: Chest radiography (CXR) (a) shows bilateral patchy lung opacities with multiple cystic lucencies (black arrows), subcutaneous emphysema (white arrow) and pneumomediastinum (arrowhead). Contrast-enhanced CT chest axial (b, c) and coronal (d) images reveal multiple cysts of varying sizes in both lungs (short arrow), pulmonary interstitial emphysema (long arrow) and pneumomediastinum (arrowhead). (e) Axial section through the abdomen shows necrotic periportal lymph nodes (short arrow), splenic infarct (long arrow) and splenic granulomas (arrowhead). (f) Follow-up CXR (after 5 months) appeared normal.
case_images: SAJR-27-2725-g002.jpg
case_images: PMC10546250_01_SAJR-27-2725-g002.jpg
case_images: F0002
case_images: CXR (Figure 2) demonstrated patchy opacities with an increased number of cystic lucencies in both lungs, along with the development of subcutaneous emphysema and pneumomediastinum. Contrast-enhanced CT (CECT) (Figure 2) revealed multiple thin-walled cysts, ground glass opacities (GGOs) and a few nodules bilaterally, along with pulmonary interstitial emphysema and pneumomediastinum. A follow-up CXR (Figure 2) 5 months later appeared normal.
case_images: PMC10546250_02
case_images: A 7-year-old boy with disseminated TB on antitubercular therapy. Chest radiography (CXR) (a) shows a loculated left pneumothorax (arrow) and cystic lucencies in both lungs. Contrast-enhanced CT chest axial (b, c) and coronal (d) images show a left pneumothorax (white arrow), cavitation (short black arrow) and innumerable variable-sized cysts on both lungs (long arrow) with a few ground glass opacities. Axial section of the abdomen (e) revealed multiple enlarged periportal, paraaortic and coeliac lymph nodes (arrows) and a hepatic granuloma (arrowhead).
case_images: SAJR-27-2725-g003.jpg
case_images: PMC10546250_02_SAJR-27-2725-g003.jpg
case_images: F0003
case_images: He underwent a CXR (Figure 3) that revealed a left loculated pneumothorax. Contrast-enhanced CT chest (Figure 3) confirmed the left pneumothorax and revealed a thick-walled cavity in the right middle lobe and multiple cysts in both lungs.
case_images: Axial CT performed 2 months prior, (a, b) showed cavitation in the right middle lobe (black arrow) with ground glass opacities in both lungs, a few tiny cysts in the right lung (arrowhead) and multiple bilateral nodules (white arrow). Axial mediastinal window (c) shows enlarged right paratracheal lymph nodes (arrow).
case_images: SAJR-27-2725-g004.jpg
case_images: PMC10546250_02_SAJR-27-2725-g004.jpg
case_images: F0004
case_images: A previous CECT chest 2 months prior (Figure 4) was reviewed and revealed GGOs, a few tiny cysts, multiple bilateral nodules, along with necrotic mediastinal and abdominal lymphadenopathy, and a few small hypodense lesions in the liver suggestive of non-calcified granulomas.
case_images: PMC10546250_03
case_images: A 13-year-old lean, underweight female with disseminated tuberculosis. Chest radiography (CXR): (a) shows a left pneumothorax (long arrow) with the infiltrates in the right mid zone (short arrow). Contrast-enhanced CT chest axial (b, c) and coronal (d) images reveal a left hydropneumothorax (white arrow) with underlying collapse, multiple bilateral centrilobular nodules showing tree-in-bud opacities and a few tiny lung cysts (circle), better seen on the zoomed-up image (c). Axial section of the abdomen (e) reveals a few liver granulomas (arrow). (f) Follow-up CXR performed after 5 months appeared normal.
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case_images: PMC10546250_03_SAJR-27-2725-g005.jpg
case_images: F0005
case_images: The CXR (Figure 5) revealed a left pneumothorax with a few infiltrates in the right mid zone. TIB pattern in both lungs, a few tiny cysts in both upper lobes, patchy consolidation in the right lower lobe, mediastinal lymph nodes with calcification, and hepatosplenomegaly with multiple liver and splenic granulomas. The patient improved on ATT and follow-up CXR (Figure 5) after 5 months revealed resolution of the radiographic findings.
case_images: PMC10546250_04
case_images: Contrast-enhanced CT chest axial (a, b) and coronal (c, d) images reveal extensive ground glass opacities and confluent nodular opacities in both lungs, along with patchy consolidation in both lower lobes (arrowhead), small lung cysts (arrows), pulmonary interstitial emphysema in the left upper lobe (long arrow in c). Left-sided intercostal drainage is in situ (arrow in b).
case_images: SAJR-27-2725-g006.jpg
case_images: PMC10546250_04_SAJR-27-2725-g006.jpg
case_images: F0006
case_images: Subsequent CECT chest (Figure 6) revealed extensive GGOs and confluent nodular opacities in both lungs with patchy consolidation in both lower lobes, along with small cysts and bronchiolar dilatation.
case_images: PMC10546250_05
case_images: An 18-month-old male, follow-up case of disseminated multidrug resistant (MDR) TB on MDR regime. Chest radiography shows multiple cystic lucencies, ill-defined opacities in both lungs and a right pneumothorax with an intercostal drainage tube in situ (arrow).
case_images: SAJR-27-2725-g007.jpg
case_images: PMC10546250_05_SAJR-27-2725-g007.jpg
case_images: F0007
case_images: TB, on an MDR regimen for 5 months, with severe acute malnutrition and recurrent pneumothoraces was being followed up. The patient had a history of a recent admission with a right-sided pneumothorax (Figure 7) and pneumonia.
case_images: Follow-up chest radiography (a) shows multiple cystic lucencies and ill-defined opacities in both lungs, predominantly in the upper zones. Contrast-enhanced CT chest axial (b, c) and coronal (d, e) images reveal resolving consolidation with associated architectural distortion (arrows in e), traction bronchiectasis in the bilateral perihilar regions and multiple cysts of varying sizes in both lungs (arrows in f), better appreciated on the minimum intensity projection (MinIP) image.
case_images: SAJR-27-2725-g008.jpg
case_images: PMC10546250_05_SAJR-27-2725-g008.jpg
case_images: F0008
case_images: A follow-up CXR (Figure 8) after 2 months showed multiple cystic lucencies and haziness in both lungs, predominantly in the upper zones. The CT chest (Figure 8) revealed resolving consolidation with associated architectural distortion and traction bronchiectasis in the perihilar regions along with multiple cysts of varying sizes in both lungs.