대한흉부영상의학회 Korean Society of Thoracic Radiology

대한흉부영상의학회 Weekly Case 메뉴

Close

대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
Advanced Search..

Close

Weekly Chest CasesCases by Disease Category

Case No : 333 Date 2004-03-13

Add to Favorites

  • Courtesy of Ki-Nam Lee, M.D., Jin-Hwa Lee, M.D., Gi-Nam Kim, M.D. / Dong-A University Hospital, Busan, Korea
  • Age/Sex 10 / M
  • Chief ComplaintIncidental finding on CXR, coughing - 3 months a
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Pleural tuberculosis
Radiologic Findings
Chest Radiograph shows multiple well-demarcated nodules in the left mid lung zone, lateral aspect.

CT scans show multiple well-demarcated nodules with small amorphous calcifications but no enhancement in the pleura. However, there is no definite lung parenchymal abnormality.
Brief Review
Tuberculous pleural effusion is considered to result from rupture of subpleural foci of necrosis into the adjacent pleural surface (1). Less commonly, it is caused by hematogenous dissemination and contamination by the adjacent infected lymph nodes. Classically, tuberculous effusion associated with acute symptom and the absence of radiographically evident parenchymal lung disease has been felt to represent primary infection. Generally, this clinical and radiologic constellation has bee seen in children and young adults (2). By contrast, tuberculous effusion with an indolent course and with parenchymal lung disease in older patients has been considered to be a manifestation of reactivation. However, such a clear-cut distinction between primary and postprimary disease cannot always be made with certainty (3).
References
1. Fraser RG, Muller NL, Colman N, Pare PD. Diagnosis of diseases of the chest 4 th ed. Philadelphia Saunders, 1999;2743-2746

2. Sahn SA. The pleura. Am Rev Respir Dis 1988; 138:84-188

3. Antoiskis D, Amin K, Barns PF. Pleuritis as a manifestation of reactivation of tuberculosis Am J Med 1990; 89:447-451
Keywords
Pleura, Infection, bacterial infection, Tuberculosis,

No. of Applicants : 33

▶ Correct Answer : 15/33,  45.5%
  • - Air force education & training command Hospital, Korea Hyukwon Chang
  • - Central Hospital of the Ministry of Interior Budapest, Hungary Kalman Judit
  • - Ewha Woman's University Hospital, Korea Yoo Kyoung Kim
  • - Geneva University Hospital, Switzerland Philippe Dumont
  • - Hangang SacredHeart Hospital, Korea Eil Seong Lee
  • - Hanyang University Hospital, Seoul, Korea Yo Won Choi
  • - Incheon Sarang Hospital, Korea Jung Hee Kim
  • - Mallinckrodt Institute of Radiology, USA Jin Mo Goo
  • - Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
  • - Royal Melbourne Hospital, Melbourne, Australia Stefan
  • - Heinze/Damien
  • - Stella/Shankara
  • - Naidoo
  • - Samsung Medical Center, Korea Sung Shine Shim
  • - Social Security Hospital, Ankara, Turkey Meric Tuzun
▶ Semi-Correct Answer : 1/33,  3.0%
  • - Hsin Chu General Hospital, Taiwan David Lin
  • Top
  • Back

Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

This website is optimized for IE 10 and above.