Anterior chest wall musculoskeletal tuberculosis

Abstract

Musculoskeletal tuberculosis (MT) occurs in 1–3% of patients with tuberculosis, while MT of the chest wall constitutes 1% to 5% of all cases of musculoskeletal MT. They are most frequently found at the margins of the sternum and along the rib shafts. Computed tomography is a useful tool for investigation in the diagnosis of abscess and in determining the extent of an abscess. Antituberculous chemotherapy and surgical excision should be started immediately after the appropriate microbiological and histological samples have been obtained if the clinical suspicion is high. We presented our experience with a 49-year-old woman who had musculoskeletal tuberculosis at the anterior chest wall together with a review of the literature on this subject. Key words: Anterior chest wall, tuberculosis, diagnosis, treatment.

Keywords

• Anterior chest wall, tuberculosis, diagnosis, treatment.

Toraks ön duvarında kas-iskelet tüberkülozu

Öz

Kas-iskelet tüberkülozları, tüm tüberküloz vakalarının %1-3\'ünü oluştururlar ve bunlardan yalnızca %1-5\'i toraks ön duvarında yerleşir. Toraks ön duvarında en sık tutulan yapılar ise sternum kenarı ve kosta gövdesidir. Bilgisayarlı tomografi lezyonların tanımlanmasında ve genişliğinin belirlenmesinde etkilidir. Eğer yüksek klinik şüphe varsa uygun histopatolojik ve mikrobiyolojik örnekler alındıktan sonra, derhal cerrahi eksizyon yapılmalı ve antitüberküloz ilaç tedavisi başlanmalıdır. Bu yazımızda, toraks ön duvarında tüberküloz tanısı alan 49 yaşında kadın hastanın güncel literatür eşliğinde irdelenmesi amaçlanmıştır.

Anahtar Kelimeler

• Toraks ön duvarı, tüberküloz, tanı, tedavi

Kaynakça

1. Papavramidis TS, Papadopoulos VN, Michalopoulos A, et al. Anterior chest wall tuberculous abscess: a case report. J Med Case Reports 2007:1:152.
2. Teo TH, Ho GH, Chaturverdi A, Khoo BK. Tuberculosis of the chest wall: unusual presentation as a breast lump. Sin- gapore Med J 2009:50:97–9.
3. Kuzucu A, Soysal O, Gunen H. The role of surgery in chest wall tuberculosis. Interact Cardiovasc Thorac Surg 2004:3:99–103.
4. Morris BS, Maheshwari M, Chalwa A. Chest wall tuberculo- sis: a review of CT appearances. Br J Radiol 2004:77:449– 57.
5. Paik HC, Chung KY, Kang JH, Maeng DH. Surgical treat- ment of tuberculous cold abscess of the chest wall. Yonsei Med J 2002:43:309–14.
6. Chung SY, Yang I, Bae SH, et al. Tuberculous abscess in ret- romammary region: CT findings. J Comput Assist Tomogr 1996:20:766–9.
7. Gaude GS, Reyas A. Tuberculosis of the chest wall without pulmonary involvement. Lung India 2008:25:135–7.
8. Lee G, Im JG, Kim JS, Kang HS, Han MC. Tuberculo- sis of the ribs: CT appearance. J Comput Assist Tomogr 1993:17:363–6.

9. Faure E, Souilamas R, Riquet M, et al. Cold abscess of the chest wall: a surgical entity? Ann Thorac Surg 1998:66:1174–8.
10. Gönül M, Gül Ü, Kiliç A, Soylu S, Demiriz M, Kubar A. Coexistence of tuberculosis verrucosa cutis with scrofulo- derma. Turk J Med Sci 2008:238:495–9.