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KMID : 0383820090670040318
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Tuberculosis and Respiratory Diseases
2009 Volume.67 No. 4 p.318 ~ p.324
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Chest Wall Tuberculosis: Clinical Features and Treatment Outcomes
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Kim Young-Joo
Chun Hee-Jung
Kim Chang-Ho
Park Jae-Yong
Jung Tae-Hoon
Lee Eung-Bae
Park Tae-In
Jeon Kyung-Nyeo
Jung Chi-Young
Cha Seung-Ick
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Abstract
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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.
Materials and 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.
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KEYWORD
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Tuberculosis, Chest wall, Surgery, Computed tomography, Bone scintigram
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