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Koo, Kim, Park, Choi, Kim, Choi, Jung, Park, Hur, Lee, Yum, Choi, Choi, and Lee: A Case of Tuberculous Pleural Effusion Developed after Percutaneous Needle Biopsy of a Solitary Pulmonary Nodule
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(3): 268-272.

Published online: 30 September 2007

DOI: https://doi.org/10.4046/trd.2007.63.3.268

A Case of Tuberculous Pleural Effusion Developed after Percutaneous Needle Biopsy of a Solitary Pulmonary Nodule

Ho Seok Koo, M.D.1, Tae Kyun Kim, M.D.1, Sung Kil Park, M.D.1, Sang Bun Choi, M.D.1, Ae Ran Kim, M.D.1, Sang Bong Choi, M.D.1, Hoon Jung, M.D.1, I-Nae Park, M.D.1, Jin-Won Hur, M.D.1, Hyuk Pyo Lee, M.D.1, Ho-Kee Yum, M.D.1, Soo Jeon Choi, M.D.1, Suk-Jin Choi, M.D.2, Hyun-Kyung Lee, M.D.1

1Department of Internal Medicine, College of Medicine, Inje University, Busan, Korea.

2Department of Radiology, College of Medicine, Inje University, Busan, Korea.

Address for correspondence: Hyun-Kyung Lee, M.D. Department of Internal Medicine, Pusan Paik Hospital, College of Medicine, Inje University, 633-165, Gae-gum-2-dong, Jin-gu, Busan, 614-735, Korea. Phone: 82-51-890-6270, Fax: 82-51-892-0273, goodoc@gmail.com

Received 7 August 2007       Accepted 30 August 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

A tuberculous pleural effusion may be a sequel to a primary infection or represent the reactivation of pulmonary tuberculosis. It is believed to result from a rupture of a subpleural caseous focus in the lung into the pleural space. It appears that delayed hypersensitivity plays a large role in the pathogenesis of a tuberculous pleural effusion. We encountered a 52 years old man with pleural effusion that developed several days after a CT guided percutaneous needle biopsy of a solitary pulmonary nodule. He was diagnosed with TB pleurisy. It is believed that his pleural effusion probably developed due to exposure of the parenchymal tuberculous focus into the pleural space during the percutaneous needle biopsy. This case might suggest one of the possible pathogeneses of tuberculous pleural effusion.

Keywords: Tuberculous pleural effusion, Percutaneous needle biopsy, Solitary pulmonary nodule

Figures and Tables

Figure 1
Chest X-ray (initial). Chest x-ray shows a well defined round nodule in right upper lobe.
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Figure 2
CT-guided percutaneous biopsy. CT-guided biopsy was done in apical segment of right upper lobe with prone position (A, B).
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Figure 3
Chest PA (A) and right decubitus view (B)(2 weeks after biopsy). Chest x-ray shows a lot of pleural fluid shifting in right thorax. Increased patch consolidation around the nodule on RUL.
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Figure 4
Chest CT (2 weeks after biopsy). CT showes linear consolidation and pleural effusion along previous biopsy tract (A-D).
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Figure 5
Chest PA (4 months later). Chest PA shows disappeared pleural effusion after anti-Tbc medication.
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Figure 6
Chest CT (4 months after anti-tbc medication). Chest CT shows no interval change of previous SPN. But pleural effusion and consolidative lesions around the nodule were disappeared (A, B).
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