HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Dov Weissberg Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weissberg, D. Search for Related Content PubMed Articles by Weissberg, D.

Ann Thorac Surg 1998;66:1178
© 1998 The Society of Thoracic Surgeons

---

Original articles: general thoracic

^a Tel Aviv University Sackler School of Medicine, and the E. Wolfson Medical Center, Holon 58100, Israel

	Invited commentary

Top Invited commentary References

 
Faure and associates have presented considerable experience with a complication of tuberculosis that is rarely seen nowadays.

Infection of the chest wall by tuberculosis occurs by hematogenous dissemination or by chest wall lymphadenitis; it rarely occurs by extension from an adjacent lung or pleura. The radiologic picture is variable. Tuberculosis may appear as cystic lesions in bony structures, which may be easily confused with neoplasms, either primary or metastatic. The lesions appear as areas of low density and may show points of increased radionuclide activity [1, 2]. Although tuberculosis of the sternum and ribs is rare, it is still the most common inflammatory disease that affects the ribs, resulting in well-demarcated areas of destruction [3]. The margins of destruction are often sclerotic, which helps in diagnosis. The psoas abscesses are a direct extension of advanced thoracolumbar osteomyelitis and are characterized by a classic radiographic presentation. In addition, radiograms may show a posterior mediastinal mass or a soft tissue mass. Reduced intervertebral disc space and calcifications within the psoas abscess are highly suggestive of tuberculosis [2].

Because of the difficulties in diagnosis, acute clinical awareness is of great importance, particularly in immunocompromised patients and in intravenous narcotic addicts who present with chest wall masses or sinuses.

Computed tomography is particularly useful in the evaluation of these lesions and was well used by Faure and associates.

Tuberculous lesions of the chest wall are best treated with antimicrobials and drainage, with debridements and excision reserved for the most extensive ones.

	References

Top Invited commentary References

 

1. Mulloy E.M.T. Tuberculosis of the sternum presenting as metastatic disease. Thorax 1995;50:1223-1224.[Abstract/Free Full Text]
2. Cordova F., Criner G.J. A 25-year-old man with back pain and an abnormal chest radiograph. Chest 1996;109:559-561.[Free Full Text]
3. Schaefer P.S., Burton B.S. Radiographic evaluation of chest wall lesions. Surg Clin N Am 1989;69:911-945.

This article has been cited by other articles:

				Y. T. Kim, K. N. Han, C. H. Kang, S. W. Sung, and J. H. Kim Complete Resection is Mandatory for Tubercular Cold Abscess of the Chest Wall Ann. Thorac. Surg., January 1, 2008; 85(1): 273 - 277. [Abstract] [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Dov Weissberg Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weissberg, D. Search for Related Content PubMed Articles by Weissberg, D.