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Chest Wall Tuberculosis: Clinical Features and Treatment Outcomes

  • Kim, Young Joo (Department of Internal Medicine and Respiratory Center, Kyungpook National University School of Medicine) ;
  • Jeon, Hee Jung (Department of Internal Medicine and Respiratory Center, Kyungpook National University School of Medicine) ;
  • Kim, Chang Ho (Department of Internal Medicine and Respiratory Center, Kyungpook National University School of Medicine) ;
  • Park, Jae Yong (Department of Internal Medicine and Respiratory Center, Kyungpook National University School of Medicine) ;
  • Jung, Tae Hoon (Department of Internal Medicine and Respiratory Center, Kyungpook National University School of Medicine) ;
  • Lee, Eung Bae (Department of Thoracic Surgery, Kyungpook National University School of Medicine) ;
  • Park, Tae In (Department of Pathology, Kyungpook National University School of Medicine) ;
  • Jeon, Kyung Nyeo (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Jung, Chi Young (Department of Internal Medicine, Fatima Hospital) ;
  • Cha, Seung Ick (Department of Internal Medicine and Respiratory Center, Kyungpook National University School of Medicine)
  • Received : 2006.07.24
  • Accepted : 2006.08.16
  • Published : 2009.10.30

Abstract

Background: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. Methods: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. Results: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5${\pm}$3.98 months with a follow-up period of 28.2${\pm}$26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. Conclusion: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.

Keywords

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