| Chest Wall Tuberculosis: Clinical Features and Treatment Outcomes. |
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Young Joo Kim, Hee Jung Jeon, Chang Ho Kim, Jae Yong Park, Tae Hoon Jung, Eung Bae Lee, Tae In Park, Kyung Nyeo Jeon, Chi Young Jung, Seung Ick Cha |
1Department of Internal Medicine and Respiratory Center, Kyungpook National University School of Medicine, Daegu, Korea. sicha@mail.knu.ac.kr
2Department of Thoracic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
3Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea.
4Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Korea.
5Department of Internal Medicine, Fatima Hospital, Daegu, Korea. |
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| 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+/-3.98 months with a follow-up period of 28.2+/-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. |
| Key Words:
Tuberculosis, Chest wall, Surgery, Computed tomography, Bone scintigram |
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