Lymphobronchial tuberculosis (LBTB) is tuberculous lymphadenopathy affecting the airways, which is particularly common in children with primary TB. Airway compression by lymphadenopathy causes downstream parenchymal pathology, which may ultimately result in irreversible lung destruction, if not treated timeously. Computed tomography (CT) is considered the “gold standard” for detecting mediastinal lymph nodes in children with TB. CT is also the best way of imaging the airways of children with LBTB. The CT findings of the parenchymal complications and associations of LBTB on CT have been described, but no severity classification was provided to aid management decisions. Identifying the parenchymal complications of LBTB and recognizing their severity has clinical relevance. Using prior publications on LBTB and post obstructive lung injury we have used an image bank of CT scans in children with pulmonary TB, presenting with airway symptoms, to create a CT severity staging of lung injury in LBTB. The staging focuses on distinguishing nonsalvageable destruction (nonenhancing or cavitated lung) from salvageable lung parenchymal disease (enhancing and noncavitated) to inform the management decisions, which range from bronchoscopic airway clearance to surgical decompression of the compressing nodes.

中文翻译：

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合并小儿淋巴支气管结核的进行性肺实质损伤的拟议 CT 分类：从可逆肺损伤到不可逆肺损伤

淋巴支气管结核 (LBTB) 是影响气道的结核性淋巴结病，在原发性结核病儿童中尤为常见。淋巴结肿大引起的气道压迫导致下游实质病变，如果不及时治疗，最终可能导致不可逆的肺破坏。计算机断层扫描 (CT) 被认为是检测结核病儿童纵隔淋巴结的“金标准”。CT 也是 LBTB 儿童气道成像的最佳方式。已经描述了实质并发症的 CT 结果和 LBTB 在 CT 上的关联，但没有提供严重程度分类来帮助管理决策。识别 LBTB 的实质并发症并识别其严重程度具有临床意义。使用先前关于 LBTB 和阻塞性肺损伤的出版物，我们使用了肺 TB 儿童的 CT 扫描图像库，呈现气道症状，以创建 LBTB 肺损伤的 CT 严重程度分期。分期的重点是区分不可挽救的破坏（非增强或空洞肺）与可挽救的肺实质疾病（增强和非空洞），以告知管理决策，范围从支气管镜气道清除到压缩淋巴结的手术减压。