GÖĞÜS DUVARINDA TÜBERKÜLOZ SOĞUK ABSESİ

Öz

22 yaşında erkek olgu, göğsünün sol ön yüzünde 2 ay önce başlayan, giderek artan ağrı ve şişlik yakınması ile başvurdu. Toraks BT'de sol hemitoraks ön yüzünde pektoral kas arkasında yer alan, iyi sınırlı,posterior kesimde subplevral alana doğru uzanan, yağ dokusunda ve kemiklerde invazyon oluşturmayan kistik bir lezyon saptandı. Öncelikle, abse ve hematom düşünülen hastanın transtorasik ince iğne biyopsisi ile, tanı sağlanamadı. Abse duvarından yapılan biyopsi sonucu, nekrotizan granülomatöz inflamasyon olarak geldi. Aspire edilen pürülan materyalin kültüründe, asido-rezistan basil (ARB) pozitif bulundu. Göğüs duvarında tüberkuloz soğuk absesi nadir görüldüğünden, olgu, literatür bilgileri eşliğinde sunuldu.

Anahtar Kelimeler

• Tüberküloz, soğuk abse, göğüs duvarı

TUBERCULOUS COLD ABSCESS OF THE CHEST WALL

Abstract

22 years old male patient applied with gradually increasing pain and swelling on the anterior wall of the left hemithoraks which was started two months ago. Cystic lesion which was well-bordered, on the anterior wall of the left hemithorax, behind pectoral muscle, reaching subpleural area posteriorly seen on Thorax CT. There was no invasion to fat tissue and bone. Initially, abscess or hematom thought but transthoracic fine needle aspiration had not given any diagnosis. True-cut biopsy from abscess wall gave the diagnosis of necrotizan granulomatous inflamation. Asido-resistan bacilli (ARB) was positive for the culture of purulan material which was aspirated from abscess. Because, tuberculous cold abscess of the chest wall is rarely seen, we presented the case with literature.

Keywords

• Tuberculosis, cold abscess, chest wall

Kaynakça

1. 1. Tavusbay N, Aksel N, Çakan A, Gülerçe G, Dereli fi, Özsöz A. Ekstrapulmoner tüberkü- lozlu olgular›m›z. Solunum Hastal›klar› 2000; 11: 294-98.
2. 2. Enarson DA, Ashley MJ, Grzybowski S, Ostapkowicz E, Dorken E. Non-respiratory tuberculosis in Canada: epidemiologic and bacteriologic features. Am J Epidemiol 1980; 112: 341-51.
3. 3. Davies PDO, Humphries MJ, Byfield SP, Nunn AJ, Darbyshire JH, Citron KM, et al. Bone and joint tuberculosis: a survey of notifications in England and Wales. J Bone Joint Surg 1984; 66B: 326-30.
4. 4. Faure E, Souilamas R, Riquet M, Chehab A, Pimpec-Barthes FL, Manac’h D, et al. Cold abscess of the chest wall: a surgical entity? Ann Thorac Surg 1998; 66: 1174-78.
5. 5. Gönen Bafl E, Numano¤lu N. Vertebra tüberkülozunda tan› ve tedavi. Tüberküloz ve Toraks Dergisi 2000; 48(3): 266-72.
6. 6. 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.
7. 7. Newton P, Sharp J, Barnes KL. Bone and joint tuberculosis in greater Manchester 1969-1979. Ann Rheum Dis 1982; 41: 1-6.
8. 8. Paik CH, Chung KY, Kang JH, Maeng DH. Surgical treatment of tuberculosis cold abscess of the chest wall. Yonsei Med J 2002; 43(3): 309-149.

9. 9. Kalac N, Güven SF, Putun ET, Özkan B, Demira¤ F. Soft tisue tuberculosis. 13th ERS annual congress Vienna, Austria, September 27-October 1, 2003. Abstracts. Europen respiratory journal 2003; 22 (45): 59.
10. 10. Seaton A, Seaton D, Leitch AG. Crofton and Douglas’s respiratory diseases. 4th ed. Edinburg: Blackwell scientific publications; 1989: 1160.
11. 11. Chen CH, Shih JF, Wang LS, Perng RP. Tuberculous subcutaneous abscess an analysis of seven cases. Tuber Lung Dis 1996; 77: 184-7.
12. 12. Adler BD, Padley SPG, Muller NL. Tuberculosis of the chest wall: CT findings. J Comput Assist Tomogr 1993; 17: 271-73.