Tuberc Respir Dis.  2007 Sep;63(3):268-272. 10.4046/trd.2007.63.3.268.

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

• Koo HS
• Kim TK
• Park SK
• Choi SB
• Kim AR
• Choi SB
• Jung H
• Park IN
• Hur JW
• Lee HP
• Yum HK
• Choi SJ
• Choi SJ
• Lee HK

• KMID: 1518418
• DOI: http://doi.org/10.4046/trd.2007.63.3.268

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.

Keyword

Tuberculous pleural effusion; Percutaneous needle biopsy; Solitary pulmonary nodule

MeSH Terms

Biopsy, Needle*
Humans
Hypersensitivity, Delayed
Lung
Middle Aged
Needles*
Pleural Effusion*
Pleurisy
Rupture
Solitary Pulmonary Nodule*
Tuberculosis, Pulmonary

Figure

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  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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