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The Ranke complex is the healed and calcified form of the Ghon complex, consisting of:

1. Calcified Ghon focus – a subpleural granulomatous lesion in the lung parenchyma.
2. Calcified ipsilateral hilar or mediastinal lymph nodes. </aside>

It represents past primary pulmonary tuberculosis (TB) that has undergone fibrosis and calcification, usually in an immunocompetent host.

Etiopathogenesis

• Causative organism: Mycobacterium tuberculosis.
• Sequence of formation:
  1. Initial pulmonary infection → Ghon focus.
  2. Spread to hilar lymph nodes → Ghon complex.
  3. Healing with fibrosis and dystrophic calcification → Ranke complex.
• Occurs commonly in childhood primary TB.
• Often an incidental radiological finding in adults.

Pathology

• Central caseous necrosis is eventually replaced by:
  • Fibrosis
  • Dystrophic calcification
• No viable bacilli are usually present in the Ranke complex, though reactivation is still possible.

Radiology

This patient was diagnosed with Ranke complex from healed and calcified primary tuberculosis lesions. This was an incidental finding in a 28 year old male with a persistent dry cough | Blachford, A. (2020, June 1). A 28-Year-Old Male with a Persistent Dry Cough. Journal of Urgent Care Medicine. https://www.jucm.com/a-28-year-old-male-with-a-persistent-dry-cough/

Differentials

Clinical Significance