Pleural tuberculosis evaluated by computed tomography.

Twenty-four cases of pleural tuberculosis (20 active and 4 inactive) were studied with computed tomography (CT). In 14 patients with proved acute tuberculous pleurisy, CT improved diagnostic accuracy by demonstrating small areas of cavitation not apparent on the chest radiograph and by detecting or confirming lymphadenopathy. In 10 patients with chronic tuberculous pleural disease, CT differentiated active from inactive infection by detecting a collection of fluid within the pleural rind. In both groups, CT also demonstrated complications such as bronchopleural fistula and involvement of the chest wall. CT can be beneficial in such cases because of its ability to show the pleural surfaces in transverse section, discriminate parenchymal from pleural disease, and quantify tissue density.