title: [A case of tuberculous abscess in the chest wall close to the thickening pleural lesion following tuberculous pleuritis].
abstract: A 33-year-old woman with a history of right tuberculous pleuritis was successfully treated in December 1992 by administration of anti-tuberculous drugs, she demonstrated residual localized pleural thickening on chest computed tomography (CT) and gradually developed a subcutaneous mass in the right chest which became apparent in March 1993. In September, chest CT revealed a periocostal abscess in the right anterior chest wall close to the localized pleural thickening. The patient was diagnosed with tuberculous abscess in the right chest wall on confirmation of acid-fast bacilli in a needle aspiration material of the abscess, and was referred to our hospital. Anti-tuberculous chemotherapy was continued but the chest abscess grew, so on January 28, 1994 she underwent a resection of the abscess, the third costal cartilage and bone, and the parietal pleural lesion connected to the abscess. Histopathological examination showed that the abscess and parietal pleural lesion were compatible with tuberculosis, i.e. both lesions consisted of caseous necrosis and epitheloid cell granuloma, but acid-fast bacilli were not demonstrated in both lesions. After one year of postoperative anti-tuberculous chemotherapy, she was followed without any therapy for 3 years and there has been no recurrence to date. When a localized thickening pleural lesion remains after tuberculous pleuritis, complication of tuberculous abscess in the chest wall should be considered.
authors.affiliation: Department of Pneumonology, National Minami-Kyushu Hospital.
authors.forename: Y
authors.initials: Y
authors.lastname: Koreeda
authors.forename: Y
authors.initials: Y
authors.lastname: Hirotsu
authors.forename: H
authors.initials: H
authors.lastname: Fukunaga
authors.forename: K
authors.initials: K
authors.lastname: Mizuno
authors.forename: Y
authors.initials: Y
authors.lastname: Tomiyama
authors.forename: K
authors.initials: K
authors.lastname: Niina
authors.forename: I
authors.initials: I
authors.lastname: Higashimoto
authors.forename: M
authors.initials: M
authors.lastname: Jounsono
authors.forename: M
authors.initials: M
authors.lastname: Kawabata
authors.forename: M
authors.initials: M
authors.lastname: Osame
mesh_terms: D000038:Abscess / Q000188:drug therapy / Q000473:pathology*; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage; D012293:Rifampin / Q000008:administration & dosage; D013896:Thoracic Diseases / Q000188:drug therapy / Q000473:pathology*; D014376:Tuberculosis / Q000188:drug therapy / Q000473:pathology*; D014396:Tuberculosis, Pleural / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin