In primary TB, which radiographic finding is commonly seen?

In primary TB, which radiographic finding is commonly seen?

• A. Cavitation in the upper lobes
• B. Ghon complex with lower-lobe disease and hilar lymphadenopathy
• C. Diffuse millet-seed nodules
• D. Pleural effusion only

Answer: (B)

Primary TB classically shows a Ghon complex on chest radiograph. This is a combination of a small parenchymal focus (Ghon focus) in the lung, usually in the mid-to-lower lung zones, with enlargement of the ipsilateral hilar lymph nodes. Together, these findings—lower-lobe disease with hilar lymphadenopathy—best reflect the initial, contained infection in primary TB and are characteristic of this stage. If healing occurs, calcification can form a Ranke complex later on. Cavitation in the upper lobes is more typical of reactivation TB, not the initial primary infection. Diffuse millet-seed nodules describe miliary TB, a hematogenous disseminated form, not the common primary pattern. Pleural effusion can occur with TB but “pleural effusion only” is not the hallmark radiographic picture of primary TB.

Primary TB classically shows a Ghon complex on chest radiograph. This is a combination of a small parenchymal focus (Ghon focus) in the lung, usually in the mid-to-lower lung zones, with enlargement of the ipsilateral hilar lymph nodes. Together, these findings—lower-lobe disease with hilar lymphadenopathy—best reflect the initial, contained infection in primary TB and are characteristic of this stage. If healing occurs, calcification can form a Ranke complex later on.

Cavitation in the upper lobes is more typical of reactivation TB, not the initial primary infection. Diffuse millet-seed nodules describe miliary TB, a hematogenous disseminated form, not the common primary pattern. Pleural effusion can occur with TB but “pleural effusion only” is not the hallmark radiographic picture of primary TB.