{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T18:42:29Z","timestamp":1779216149805,"version":"3.51.4"},"reference-count":5,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T00:00:00Z","timestamp":1548374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>A 62\u2010year\u2010old healthy man presented to our hospital due to a persistent fever of up to 38\u00b0C for one week. Thoracic computed tomography showed right pleural effusion with multiple large nodules up to 7 cm in diameter composed of numerous discrete small nodules like fireworks, the so\u2010called \u201ccluster\u201d signs. Some of the large nodules had a hyper\u2010dense portion centrally surrounded by partially discrete small nodules, not as densely assembled, suggestive of the \u201cgalaxy\u201d sign. The repeated acid\u2010fast sputum smears and both bronchial washings were all negative for <jats:italic>Mycobacterium tuberculosis<\/jats:italic>, but the acid\u2010fast culture of sputum taken soon after the first bronchoscopy, and pleural fluid, turned out to be positive for <jats:italic>M. tuberculosis<\/jats:italic> at six\u2009weeks after admission. The present case clearly demonstrates that the \u201cgalaxy\u201d and \u201ccluster\u201d signs are red herring signs of the low rates of isolating <jats:italic>M. tuberculosis<\/jats:italic>, which should be differentiated from pulmonary sarcoidosis.<\/jats:p>","DOI":"10.1002\/rcr2.398","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T08:04:12Z","timestamp":1548403452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Multiple huge \u201ccluster\u201d and \u201cgalaxy\u201d signs on chest radiography in a patient with pulmonary tuberculosis"],"prefix":"10.1002","volume":"7","author":[{"given":"Miku","family":"Oda","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine Kyorin University School of Medicine  Mitaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0502-8128","authenticated-orcid":false,"given":"Takeshi","family":"Saraya","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Kyorin University School of Medicine  Mitaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Shirai","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Kyorin University School of Medicine  Mitaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narishige","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Kyorin University School of Medicine  Mitaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masachika","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Pathology Kyorin University School of Medicine  Mitaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Takizawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Kyorin University School of Medicine  Mitaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,25]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.178.6.1781389"},{"key":"e_1_2_4_3_1","first-page":"495","article-title":"The \"sarcoid cluster sign\". A new sign in high resolution chest CT","volume":"51","author":"Herraez Ortega I","year":"2009","journal-title":"Radiologia"},{"key":"e_1_2_4_4_1","first-page":"247","article-title":"Clinical significance of the \u201cgalaxy sign\u201d in a Japanese single\u2010center cohort","volume":"33","author":"Koide T","year":"2016","journal-title":"Sarcoidosis Vasc. 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