Mathlouthi A, Ben M'Rad S, Merai S, Friaa T, Mestiri I, Ben Miled K, Djenayah F
Service de Pneumologie, Hôpital A. Mami, Tunis, Tunisie.
Rev Pneumol Clin. 1998 Sep;54(4):182-6.
The thoracic wall is an uncommon localization for tuberculosis, accounting for an estimated 1 to 5% of all cases of bone and joint tuberculosis which themselves account for 15% of all extrapulmonary localizations. Four patients were hospitalized for tuberculosis of the thoracic wall. The first patient, aged 22 years, had sternal tuberculosis with multiple bone localizations. The second patient was 37 years old and had a cold abscess of the peristernal soft tissues with several other bone localizations devoid of clinical manifestations. A third 37-year-old patient had a cold intercostal abscess revealed by a mass in the upper left quadrant of the left breast. In the last patient, 50 years old, tuberculosis of the ribs was associated with a cold tumor of the knee. Together with cases reported in the literature, these observations demonstrate the difficult diagnostic situation presented by tuberculosis of the thoracic wall. Treatment is based on long-duration multi-drug therapy. Surgical resection is rarely indicated. Cure was achieved in our four cases.
胸壁是结核病的罕见发病部位，约占所有骨与关节结核病例的1%至5%，而骨与关节结核占所有肺外结核发病部位的15%。有4例胸壁结核患者住院治疗。首例患者为22岁，患有胸骨结核并伴有多处骨骼病变。第二例患者37岁，患有胸骨旁软组织寒性脓肿，还有其他几处骨骼病变但无临床表现。第三例37岁患者，左乳左上象限有一肿块，经检查为肋间寒性脓肿。最后一例患者50岁，肋骨结核合并膝关节寒性肿瘤。结合文献报道的病例，这些观察结果表明胸壁结核的诊断情况较为困难。治疗基于长期多药联合疗法。很少需要进行手术切除。我们的4例患者均已治愈。
