Browse > Article
http://dx.doi.org/10.4046/trd.2009.67.4.318

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)
Publication Information
Tuberculosis and Respiratory Diseases / v.67, no.4, 2009 , pp. 318-324 More about this Journal
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
Tuberculosis; Chest wall; Surgery; Computed tomography; Bone scintigram;
Citations & Related Records

Times Cited By SCOPUS : 0
연도 인용수 순위
  • Reference
1 Mathlouthi A, Ben M'Rad S, Merai S, Friaa T, Mestiri I, Ben Miled K, et al. Tuberculosis of the thoracic wall: presentation of 4 personal cases and review of the literature. Rev Pneumol Clin 1998;54:182-6   PUBMED
2 Garcia S, Combalia A, Serra A, Segur JM, Ramon R. Unusual locations of osteoarticular tuberculosis. Arch Orthop Trauma Surg 1997;116:321-3   DOI   PUBMED
3 Hopewell P, Cynamon M, Starke J, Iseman M, O'Brien R. Evaluation of new anti-infective drugs for the treatment and prevention of tuberculosis. Clin Infect Dis 1992;15 Suppl 1:S282-95   DOI
4 Hulnick DH, Naidich DP, McCauley DI. Pleural tuberculosis evaluated by computed tomography. Radiology 1983;149:759-65   DOI   PUBMED
5 Gayler BW, Donner MW. Radiographic changes of the ribs. Am J Med Sci 1967;253:586-619   PUBMED
6 Tatelman M, Drouillard EJ. Tuberculosis of the ribs. Am J Roentgenol Radium Ther Nucl Med 1953;70:923-35   PUBMED
7 Ward AS. Superficial abscess formation: an unusual presenting feature of tuberculosis. Br J Surg 1971;58:540-3   DOI   ScienceOn
8 Dutt AK, Moers D, Stead WW. Short-course chemotherapy for extrapulmonary tuberculosis: nine years' experience. Ann Intern Med 1986;104:7-12   DOI   PUBMED   ScienceOn
9 Khalil A, Le Breton C, Tassart M, Korzec J, Bigot J, Carette M. Utility of CT scan for the diagnosis of chest wall tuberculosis. Eur Radiol 1999;9:1638-42   DOI   ScienceOn
10 Chen CH, Shih JF, Wang LS, Perng RP. Tuberculous subcutaneous abscess: an analysis of seven cases. Tuber Lung Dis 1996;77:184-7   DOI   ScienceOn
11 Hsu HS, Wang LS, Wu YC, Fahn HJ, Huang MH. Management of primary chest wall tuberculosis. Scand J Thorac Cardiovasc Surg 1995;29:119-23   DOI   PUBMED
12 Chang DS, Rafii M, McGuinness G, Jagirdar JS. Primary multifocal tuberculous osteomyelitis with involvement of the ribs. Skeletal Radiol 1998;27:641-5   DOI   ScienceOn
13 Paik HC, Chung KY, Kang JH, Maeng DH. Surgical treatment of tuberculous cold abscess of the chest wall. Yonsei Med J 2002;43:309-14   DOI   PUBMED
14 Martini M, Ouahes M. Bone and joint tuberculosis: a review of 652 cases. Orthopedics 1988;11:861-6   PUBMED
15 Eid A, Chaudry N, el-Ghoroury M, Hawasli A, Salot WL, Khatib R. Multifocal musculoskeletal cystic tuberculosis without systemic manifestations. Scand J Infect Dis 1994;26:761-4   DOI   ScienceOn
16 Faure E, Souilamas R, Riquet M, Chehab A, Le Pimpec-Barthes F, Manac'h D, et al. Cold abscess of the chest wall: a surgical entity? Ann Thorac Surg 1998;66:1174-8   DOI   ScienceOn
17 Morris BS, Maheshwari M, Chalwa A. Chest wall tuberculosis: a review of CT appearances. Br J Radiol 2004;77:449-57   DOI   ScienceOn
18 Chang JH, Kim SK, Lee WY. Diagnostic issues in tuberculosis of the ribs with a review of 12 surgically proven cases. Respirology 1999;4:249-53   DOI   ScienceOn
19 Blunt SB, Harries MG. Discrete pleural masses without effusion in a young man: an unusual presentation of tuberculosis. Thorax 1989;44:436-7   DOI   ScienceOn
20 Brown RB, Trenton J. Chronic abscesses and sinuses of the chest wall:the treatment of costal chondritis and sternal osteomyelitis. Ann Surg 1952;135:44-51   DOI   ScienceOn