Tree-in-bud sign and bronchiectasis

Discussion:

Chest x-ray in a 60 year old patient of Asian extraction demonstrates faint reticulonodular opacities.

CT confims numerous centrilobular nodules with opacified distal bronchioles (tree-in-bud sign) and bronchiectasis.

These findings most likely represents pulmonary TB or MAC despite negative induced sputum specimens. 

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