Skip to main content
SpringerLink
Log in

Imaging of Urogenital, Adrenal, and Breast Tuberculosis

  • Chapter
  • First Online:
Book cover Imaging of Tuberculosis

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Many patients presenting with extrapulmonary tuberculosis (TB) have urogenital TB. Urogenital TB can easily be overlooked owing to non-specific symptoms, chronic and cryptic or protean clinical manifestations, and lack of clinician awareness of the possibility of TB. Although the definitive diagnosis of urogenital TB is established by culturing Mycobacterium tuberculosis or by DNA identification, the diagnosis is often difficult and delayed. Abnormal abdominal or chest radiographs are useful as the initial diagnostic investigation in a large proportion of infected patients. Intravenous urography and hysterosalpingography, the standard imaging modalities for the evaluation of urogenital TB in the past, are infrequently used nowadays in the era of cross-sectional imaging. Computed tomography, magnetic resonance imaging, and ultrasound imaging are useful, depending on which urogenital organs are investigated. Imaging features of TB affecting the adrenal gland and breast are also addressed. Awareness of the imaging findings enables the radiologist to raise the diagnostic suspicion in a timely manner, for initiation of prompt treatment and prevention of complications. Imaging can aid in localizing the site, extent, and effect of the disease, obtaining tissue samples for diagnosis, planning medical or surgical management, and monitoring the response to treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

BCG:

Bacillus Calmette–Guérin

CT:

Computed tomography

CTU:

Computed tomographic urography

HIV:

Human immunodeficiency virus

HSG:

Hysterosalpingography

IVU:

Intravenous urography

MRI:

Magnetic resonance imaging

PET:

Positron-emission tomography

TB:

Tuberculosis

US:

Ultrasound

References

  • Aziz EM, Abdelhak K, Hassan FM (2016) Tuberculous prostatitis: mimicking a cancer. Pan Afr Med J 25:130

    Article  PubMed  PubMed Central  Google Scholar 

  • Bansal P, Bansal N (2015) The surgical management of urogenital tuberculosis our experience and long-term follow-up. Urol Ann 7:49–52

    Article  PubMed  PubMed Central  Google Scholar 

  • Baykan AH, Sayiner HS, Inan I et al (2021) Primary breast tuberculosis: imaging findings of a rare disease. Insights Imaging 12:19

    Article  PubMed  PubMed Central  Google Scholar 

  • Berta M, Sturm G, Juri L et al (2011) Bacteriological diagnosis of renal tuberculosis: an experience at the regional tuberculosis laboratory in Cordoba Province, Argentina. Rev Argent Microbiol 43:191–194

    PubMed  Google Scholar 

  • Borthwick WM (1946) The pathogenesis of tuberculous epididymitis. Edinb Med J 53:55–70

    CAS  PubMed  PubMed Central  Google Scholar 

  • Bour L, Schull A, Delongchamps NB et al (2013) Multiparametric MRI features of granulomatous prostatitis and tubercular prostate abscess. Diagn Interv Imaging 94:84–90

    Article  CAS  PubMed  Google Scholar 

  • Chakaya J, Khan M, Ntoumi F et al (2021) Global Tuberculosis Report 2020—reflections on the global TB burden, treatment and prevention efforts. Int J Infect Dis 11. S1201-9712(21)00193-4

    Google Scholar 

  • Chattopadhyay A, Bhatnagar V, Agarwala S et al (1997) Genitourinary tuberculosis in pediatric surgical practice. J Pediatr Surg 32:1283–1286

    Article  CAS  PubMed  Google Scholar 

  • Chen Y, Liu M, Guo Y (2010) Proton magnetic resonance spectroscopy in prostate tuberculosis. Urology 75:1065–1066

    Article  PubMed  Google Scholar 

  • Chen Y, Wu P, Fu L et al (2019) Multicentre evaluation of Xpert MTB/RIF assay in detecting urinary tract tuberculosis with urine samples. Sci Rep 9:11053

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Cheng Y, Huang L, Zhang X et al (2015) Multiparametric magnetic resonance imaging characteristics of prostate tuberculosis. Korean J Radiol 16:846–852

    Article  PubMed  PubMed Central  Google Scholar 

  • Drudi FM, Laghi A, Iannicelli E et al (1997) Tubercular epididymitis and orchitis: US patterns. Eur Radiol 7:1076–1078

    Article  CAS  PubMed  Google Scholar 

  • Dyer RB, Chen MY, Zagoria RJ (1998) Abnormal calcifications in the urinary tract. Radiographics 18:1405–1424

    Article  CAS  PubMed  Google Scholar 

  • Engin G, Acunas B, Acunas G et al (2000) Imaging of extrapulmonary tuberculosis. Radiographics 20:471–488. quiz 529-530,532

    Article  CAS  PubMed  Google Scholar 

  • Farrokh D, Alamdaran A, Feyzi Laeen A et al (2019) Tuberculous mastitis: a review of 32 cases. Int J Infect Dis 87:135–142

    Article  CAS  PubMed  Google Scholar 

  • Figueiredo AA, Lucon AM, Junior RF et al (2008) Epidemiology of urogenital tuberculosis worldwide. Int J Urol 15:827–832

    Article  PubMed  Google Scholar 

  • Furin J, Cox H, Pai M (2019) Tuberculosis. Lancet 393:1642–1656

    Google Scholar 

  • Gambhir S, Ravina M, Rangan K et al (2017) Imaging in extrapulmonary tuberculosis. Int J Infect Dis 56:237–247

    Article  PubMed  Google Scholar 

  • Gatongi DK, Gitau G, Kay V et al (2005) Female genital tuberculosis. Obstet Gynaecol 7:75–79

    Google Scholar 

  • Gaudiano C, Tadolini M, Busato F et al (2017) Multidetector CT urography in urogenital tuberculosis: use of reformatted images for the assessment of the radiological findings. A pictorial essay. Abdom Radiol (NY) 42:2314–2324

    Article  Google Scholar 

  • Goel A, Dalela D (2008) Options in the management of tuberculous ureteric stricture. Indian J Urol 24:376–381

    Article  PubMed  PubMed Central  Google Scholar 

  • Gon S, Bhattacharyya A, Majumdar B et al (2013) Tubercular mastitis—a great masquerader. Turk Patoloji Derg 29:61–63

    PubMed  Google Scholar 

  • Grace GA, Devaleenal DB, Natrajan M (2017) Genital tuberculosis in females. Indian J Med Res 145:425–436

    PubMed  PubMed Central  Google Scholar 

  • Guo YK, Yang ZG, Li Y et al (2007) Uncommon adrenal masses: CT and MRI features with histopathologic correlation. Eur J Radiol 62:359–370

    Article  PubMed  Google Scholar 

  • Harisinghani MG, Mcloud TC, Shepard JA et al (2000) Tuberculosis from head to toe. Radiographics 20:449–470. quiz 528–529, 532

    Google Scholar 

  • Jung YY, Kim JK, Cho KS (2005) Genitourinary tuberculosis: comprehensive cross-sectional imaging. AJR Am J Roentgenol 184:143–150

    Article  PubMed  Google Scholar 

  • Kenney PJ (1990) Imaging of chronic renal infections. AJR Am J Roentgenol 155:485–494

    Article  CAS  PubMed  Google Scholar 

  • Kohli M, Schiller I, Dendukuri N et al (2018) Xpert((R)) MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance. Cochrane Database Syst Rev 8:CD012768

    PubMed  Google Scholar 

  • Kulchavenya E (2013) Best practice in the diagnosis and management of urogenital tuberculosis. Ther Adv Urol 5:143–151

    Article  PubMed  PubMed Central  Google Scholar 

  • Kulchavenya E (2014) Extrapulmonary tuberculosis: are statistical reports accurate? Ther Adv Infect Dis 2:61–70

    PubMed  PubMed Central  Google Scholar 

  • Kulchavenya E, Kholtobin D (2015) Diseases masking and delaying the diagnosis of urogenital tuberculosis. Ther Adv Urol 7:331–338

    Article  PubMed  PubMed Central  Google Scholar 

  • Kulchavenya E, Brizhatyuk E, Khomyakov V (2014) Diagnosis and therapy for prostate tuberculosis. Ther Adv Urol 6:129–134

    Article  PubMed  PubMed Central  Google Scholar 

  • Kulchavenya E, Naber K, Bjerklund Johansen TE (2016) Urogenital tuberculosis: classification, diagnosis, and treatment. Eur Urol Suppl 15:112–121

    Article  Google Scholar 

  • Lam KY, Lo CY (2001) A critical examination of adrenal tuberculosis and a 28-year autopsy experience of active tuberculosis. Clin Endocrinol (Oxf) 54:633–639

    Google Scholar 

  • Lamm DL, Stogdill VD, Stogdill BJ et al (1986) Complications of bacillus Calmette-Guerin immunotherapy in 1278 patients with bladder cancer. J Urol 135:272–274

    Article  CAS  PubMed  Google Scholar 

  • Merchant S, Bharati A, Merchant N (2013) Tuberculosis of the genitourinary system-urinary tract tuberculosis: renal tuberculosis—part I. Indian J Radiol Imaging 23:46–63

    Google Scholar 

  • Muneer A, Macrae B, Krishnamoorthy S et al (2019) Urogenital tuberculosis—epidemiology, pathogenesis and clinical features. Nat Rev Urol 16:573–598

    Google Scholar 

  • Muttarak M, Peh WCG, Lojanapiwat B et al (2001) Tuberculous epididymitis and epididymo-orchitis: sonographic appearances. AJR Am J Roentgenol 176:1459–1466

    Article  CAS  PubMed  Google Scholar 

  • Muttarak M, Pojchamarnwiputh S, Chaiwun B (2002) Mammographic features of tuberculous axillary lymphadenitis. Australas Radiol 46:260–263

    Article  CAS  PubMed  Google Scholar 

  • Muttarak M, Chiangmai WN, Lojanapiwat B (2005) Tuberculosis of the genitourinary tract: imaging features with pathological correlation. Singapore Med J 46:568–575

    Google Scholar 

  • Pattamapaspong N, Muttarak M, Sivasomboon C (2011) Tuberculosis arthritis and tenosynovitis. Semin Musculoskelet Radiol 15:459–469

    Article  PubMed  Google Scholar 

  • Ramachandran A, Das CJ, Razik A (2021) Male genital tract tuberculosis: a comprehensive review of imaging findings and differential diagnosis. Abdom Radiol (NY) 46:1677–1686

    Article  Google Scholar 

  • Rui X, Li XD, Cai S et al (2008) Ultrasonographic diagnosis and typing of renal tuberculosis. Int J Urol 15:135–139

    Article  PubMed  Google Scholar 

  • Sakr AA, Fawzy RK, Fadaly G et al (2004) Mammographic and sonographic features of tuberculous mastitis. Eur J Radiol 51:54–60

    Article  PubMed  Google Scholar 

  • Shah HU, Sannananja B, Baheti AD et al (2015) Hysterosalpingography and ultrasonography findings of female genital tuberculosis. Diagn Interv Radiol 21:10–15

    Article  PubMed  Google Scholar 

  • Shinde SR, Chandawarkar RY, Deshmukh SP (1995) Tuberculosis of the breast masquerading as carcinoma: a study of 100 patients. World J Surg 19:379–381

    Article  CAS  PubMed  Google Scholar 

  • Subramanyam P, Palaniswamy SS (2015) Dual time point (18)F-FDG PET/CT imaging identifies bilateral renal tuberculosis in an immunocompromised patient with an unknown primary malignancy. Infect Chemother 47:117–119

    Article  PubMed  PubMed Central  Google Scholar 

  • Teo TH, Ho GH, Chaturverdi A et al (2009) Tuberculosis of the chest wall: unusual presentation as a breast lump. Singapore Med J 50:e97–e99

    Google Scholar 

  • Vijayaraghavan SB, Kandasamy SV, Arul M et al (2004) Spectrum of high-resolution sonographic features of urinary tuberculosis. J Ultrasound Med 23:585–594

    Article  PubMed  Google Scholar 

  • Wang LJ, Wong YC, Chen CJ et al (1997) CT features of genitourinary tuberculosis. J Comput Assist Tomogr 21:254–258

    Article  CAS  PubMed  Google Scholar 

  • Yadav S, Singh P, Hemal A et al (2017) Genital tuberculosis: current status of diagnosis and management. Transl Androl Urol 6:222–233

    Article  PubMed  PubMed Central  Google Scholar 

  • Yang DM, Yoon MH, Kim HS et al (2001) Comparison of tuberculous and pyogenic epididymal abscesses: clinical, gray-scale sonographic, and color Doppler sonographic features. AJR Am J Roentgenol 177:1131–1135

    Google Scholar 

  • Yang DM, Kim SH, Kim HN et al (2003) Differential diagnosis of focal epididymal lesions with gray scale sonographic, color Doppler sonographic, and clinical features. J Ultrasound Med 22:135–142. quiz 143–144

    Google Scholar 

  • Zachoval R, Nencka P, Vasakova M et al (2018) The incidence of subclinical forms of urogenital tuberculosis in patients with pulmonary tuberculosis. J Infect Public Health 11:243–245

    Article  PubMed  Google Scholar 

  • Zhao WH, Hao M (2014) Pelvic inflammatory disease: a retrospective clinical analysis of 1922 cases in North China. Gynecol Obstet Invest 77:169–175

    Google Scholar 

Download references

Acknowledgements

We would like to thank Associate Professor Suwalee Pojchamarnwiputh and Assistant Professor Wittanee Na Chiangmai for their invaluable advice.

Author information

Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Thanat Kanthawang, Malai Muttarak & Puwitch Charoenchue

Authors
  1. Thanat Kanthawang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Malai Muttarak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Puwitch Charoenchue
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thanat Kanthawang .

Editor information

Editors and Affiliations

  1. Department of Radiology, Mohamed Kassab Orthopedic Institute, Tunis, Tunisia

    Mohamed Fethi Ladeb

  2. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore

    Wilfred C. G. Peh

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kanthawang, T., Muttarak, M., Charoenchue, P. (2022). Imaging of Urogenital, Adrenal, and Breast Tuberculosis. In: Ladeb, M.F., Peh, W.C.G. (eds) Imaging of Tuberculosis. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-031-07040-2_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-07040-2_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-07039-6

  • Online ISBN: 978-3-031-07040-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation