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A Proposed CT Classification of Progressive Lung Parenchymal Injury Complicating Paediatric Lymphobronchial Tuberculosis -- from reversible to irreversible lung injury
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  • Savvas Andronikou,
  • Susan Lucas,
  • Andrea Zouvani,
  • Pierre Goussard
Savvas Andronikou
The Children's Hospital of Philadelphia

Corresponding Author:[email protected]

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Susan Lucas
University of the Witwatersrand
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Andrea Zouvani
University of Glasgow
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Pierre Goussard
Stellenbosch University
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Abstract 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. 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 recognising 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 non-salvageable destruction [non-enhancing or cavitated lung] from salvageable lung parenchymal disease [enhancing and non-cavitated] to inform the management decisions, which range from bronchoscopic airway clearance to surgical decompression of the compressing nodes.
20 Nov 2020Submitted to Pediatric Pulmonology
23 Nov 2020Submission Checks Completed
23 Nov 2020Assigned to Editor
26 Nov 2020Reviewer(s) Assigned
10 Jan 2021Review(s) Completed, Editorial Evaluation Pending
12 Jan 2021Editorial Decision: Revise Major
09 Apr 20211st Revision Received
10 Apr 2021Submission Checks Completed
10 Apr 2021Assigned to Editor
10 Apr 2021Reviewer(s) Assigned
13 May 2021Review(s) Completed, Editorial Evaluation Pending
14 May 2021Editorial Decision: Revise Minor
28 Jun 20212nd Revision Received
29 Jun 2021Submission Checks Completed
29 Jun 2021Assigned to Editor
29 Jun 2021Reviewer(s) Assigned
17 Aug 2021Review(s) Completed, Editorial Evaluation Pending
19 Aug 2021Editorial Decision: Accept