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Abstract
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.
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.
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Figure 1.
Chest CT scan showing a soft tissue mass (arrow) with a central low density and with peripheral rim enhancement in the inner and outer sides of the ribs (A), and only in the outer side (B). The subcuatenous fat layer (arrow) was only involved in one lesion (C).
Figure 2.
Six- or less than six-month regimen versus nine- or more than nine-month regimen, which was stratified by time intervals from the end of the previous medication to symptom onset of chest wall tuberculosis. The numbers mean the duration of antituberculous medication, and solid (●) and blank (○) circles indicate cured and recurred cases, respectively.
Table 1.
Clinical characteristics of the patients (n=26)
Table 2.
Chest CT findings
Table 3.
Bone scintigram (n=10)
| Surgical or pathological bone involvement | Bone scintigram | |
|---|---|---|
| Positive hot uptake | Negative hot uptake | |
| Present | 7 | 1 |
| Absent | 0 | 2 |
Table 4.
Microbiologic and cytopathologic results
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