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Tuberculosis of the chest wall without pulmonary involvement.

Gaude GS, Reyas A - Lung India (2008)

Bottom Line: Skeletal tuberculosis is usually seen in association with primary pulmonary form.Pulmonary tuberculosis of the chest wall is a rare entity.We herein report a case of tuberculosis of the chest wall without pulmonary involvement that presented with big ulcer in the anterior chest wall and responded completely to the antituberculosis therapy without any surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Professor and Head Department of Pulmonary Medicine, J.N. Medical College, Belgaum, Karnataka, India.

ABSTRACT
Skeletal tuberculosis is usually seen in association with primary pulmonary form. Pulmonary tuberculosis of the chest wall is a rare entity. We herein report a case of tuberculosis of the chest wall without pulmonary involvement that presented with big ulcer in the anterior chest wall and responded completely to the antituberculosis therapy without any surgical intervention.

No MeSH data available.


Related in: MedlinePlus

Normal chest radiograph film without any mediastinal lymphadenopathy.
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Figure 0002: Normal chest radiograph film without any mediastinal lymphadenopathy.

Mentions: Examination showed averagely built male with BMI of 23.5, no clubbing and lymph adenopathy. Respiratory system examination was normal. Local examination revealed a large solitary oval ulcer over left lower chest in 6th intercoastal space in the midclavicular region of 6.5cms X 4.5 cm in dimensions, with undermined edges, having yellowish slough with scanty serous discharge (Fig. 1). The ulcer was extending deep into the skin almost to an extent of 2.5cms involving subcutaneous tissue with raised edges and had vegetations and crusts; it was slightly tender, and surrounding skin was indurated. There was no involvement of the regional lymph nodes. Tuberculosis was kept in mind in investigating this ulcer as it was progressing over a period of 3 months. His hemogram was normal, HIV and VDRL were negative. Chest radiograph was normal with no evidence of hilar adenopathy (Fig. 2). CT Scan of the thorax was also performed, which revealed no parenchymal infiltrations or cavity, and also there was no evidence of any mediastinal lymphadenopathy (Fig. 3). PPD test was 16 mm. Biopsy from the edge of the ulcer was done which showed granulomas consisting of epitheloid cells, Langhans' type of giant cells, lymphocytes and macrophages (Fig. 4). Fungal elements were negative. The findings were suggestive of tuberculous ulcer. As the diagnosis of tuberculosis of the chest wall was made, and there were no primary involvement of the lungs, every effort was made to find out any primary lesions anywhere in the body. This included examination of the oral cavity, ears, skin, conjunctiva, abdomen, kidneys and the bones. Abdominal ultrasonography did not revealed any mass or cystic lesions in the intestines or in the kidneys. But no primary lesion anywhere in the body could be identified.


Tuberculosis of the chest wall without pulmonary involvement.

Gaude GS, Reyas A - Lung India (2008)

Normal chest radiograph film without any mediastinal lymphadenopathy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822333&req=5

Figure 0002: Normal chest radiograph film without any mediastinal lymphadenopathy.
Mentions: Examination showed averagely built male with BMI of 23.5, no clubbing and lymph adenopathy. Respiratory system examination was normal. Local examination revealed a large solitary oval ulcer over left lower chest in 6th intercoastal space in the midclavicular region of 6.5cms X 4.5 cm in dimensions, with undermined edges, having yellowish slough with scanty serous discharge (Fig. 1). The ulcer was extending deep into the skin almost to an extent of 2.5cms involving subcutaneous tissue with raised edges and had vegetations and crusts; it was slightly tender, and surrounding skin was indurated. There was no involvement of the regional lymph nodes. Tuberculosis was kept in mind in investigating this ulcer as it was progressing over a period of 3 months. His hemogram was normal, HIV and VDRL were negative. Chest radiograph was normal with no evidence of hilar adenopathy (Fig. 2). CT Scan of the thorax was also performed, which revealed no parenchymal infiltrations or cavity, and also there was no evidence of any mediastinal lymphadenopathy (Fig. 3). PPD test was 16 mm. Biopsy from the edge of the ulcer was done which showed granulomas consisting of epitheloid cells, Langhans' type of giant cells, lymphocytes and macrophages (Fig. 4). Fungal elements were negative. The findings were suggestive of tuberculous ulcer. As the diagnosis of tuberculosis of the chest wall was made, and there were no primary involvement of the lungs, every effort was made to find out any primary lesions anywhere in the body. This included examination of the oral cavity, ears, skin, conjunctiva, abdomen, kidneys and the bones. Abdominal ultrasonography did not revealed any mass or cystic lesions in the intestines or in the kidneys. But no primary lesion anywhere in the body could be identified.

Bottom Line: Skeletal tuberculosis is usually seen in association with primary pulmonary form.Pulmonary tuberculosis of the chest wall is a rare entity.We herein report a case of tuberculosis of the chest wall without pulmonary involvement that presented with big ulcer in the anterior chest wall and responded completely to the antituberculosis therapy without any surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Professor and Head Department of Pulmonary Medicine, J.N. Medical College, Belgaum, Karnataka, India.

ABSTRACT
Skeletal tuberculosis is usually seen in association with primary pulmonary form. Pulmonary tuberculosis of the chest wall is a rare entity. We herein report a case of tuberculosis of the chest wall without pulmonary involvement that presented with big ulcer in the anterior chest wall and responded completely to the antituberculosis therapy without any surgical intervention.

No MeSH data available.


Related in: MedlinePlus