Chest Wall Tuberculosis: CT Findings in 14 Patients

Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Dong Woo; Juhng, Seon Kwan; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul

Abstract

PURPOSE
To present CT findings of chest wall tuberculosis.
MATERIALS AND METHODS
CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions.
RESULTS
All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rimenhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%)had evidence of pulmonary tuberculosis ; active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%).
CONCLUSION
On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggestdirect inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis.