Clinical and radiological characteristics of children with calcinates in the intrathoracic lymph nodes

Abstract

Objective: to study the clinical and radiological manifestations of tuberculosis infection in children with newly diagnosed specific lesions of the intrathoracic lymph nodes in the calcification phase. Material and methods. The results of clinical, laboratory, radiological (MSCT of the chest) and immunological (Mantoux and Diaskintest) examinations of 138 children up to 14 years of age with newly diagnosed calcification in the intrathoracic lymph nodes, observed in 2017–2019, were studied. Three groups of children were identified: 1 — with small residual post-TB changes (SRC, n=68); 2 — with large residual changes (LRC, n=38); 3 — with newly diagnosed tuberculosis in the consolidation and calcification phase (n=32). All children had no respiratory or intoxication symptoms. Results and conclusions. In 2017–2019 (screening of the pediatric population using Diaskintest), for every 3 identified patients with active tuberculosis, there was 1 patient with newly diagnosed lymph node calcifications; in 2020–2022 (the period of COVID-19 epidemic restrictions), this ratio was 4:1 due to the decreased number of patients with post-tuberculosis residual changes. Half of the children with SRC and with tuberculosis in the phase of reverse development had calcifications in one group of lymph nodes, in children with LRC — on average in 4.7±0.8 groups of intrathoracic lymph nodes. The most frequent lesion was noted of the bronchopulmonary group of lymph nodes. Contact with a tuberculosis patient was 7 times more often in children with active tuberculosis than in children with lymph node calcifications (OR=7.444). Most children, regardless of the severity of residual changes and with tuberculosis in the phase of regression, have a high degree of sensitivity to immunological tuberculosis tests. The average time of spontaneous recovery from tuberculosis was 4.4±1.6 years, and the onset of calcification of active tuberculosis was 1.9±1.3 years, p<0.05.