Clinical Course of Apical Pulmonary TB

Outcome/Fate/Clinical Course/Sequelae of Apical Pulmonary TB

• Clinical outcomes from apical pulmonary tuberculosis can vary significantly among patients.
• Rarely, apical TB may lead to fibrocalcific scarring, indicating arrested disease progression.

Progressive Pulmonary TB

• Extension of pulmonary TB may occur, involving other lung areas.
• Pleural involvement can result in adhesive pleural fibrosis, which may present as:
  • Pleurisy with effusion, characterized by fluid accumulation between pleurae.
  • TB empyema, indicating a collection of pus in the pleural cavity.
• Erosion into bronchial airways leads to cavitation, resulting in open cases of TB. This can cause:
  • Seeding of the mucosal lining in airways, possibly leading to endotracheobronchial or laryngeal TB.

Gastrointestinal Involvement

• Infected sputum may be coughed up and swallowed, causing small and large bowel infections.
• This can lead to circumferential lympho-haematogenous spread, resulting in transverse ulcers known as girdle ulcers in the intestines.

Miliary TB

• Lymphohaematogenous dissemination from apical TB may cause miliary TB, characterized by:
  • Presence of small yellow-white lesions resembling millet seeds in the lungs.
• Erosion of the pulmonary artery can result in miliary TB affecting both lungs.
• Erosion of the pulmonary vein can lead to systemic spread of miliary TB throughout the body.