Treatment of huge chronic tuberculous empyema with cardiopulmonary dysfunction. Drainage of empyemal space by closed thoracostomy in chronic tuberculous empyema is generally contraindicated because of the possibility of empyema necessitatis and ascending infection. But in case that serious cardiopulmonary dysfunction is present, drainage of empyema and decompression is necessary. We experienced a case in which chronic tuberculous empyema was big enough to cause mediastinal shifting and cardiopulmonary failure. Immediate drainage of pleural cavity with tube thoracostomy was performed. Afterward, pleuropneumonectomy was done following cyclic irrigation for one month. The patient had successful postoperative course without any evidence of complication or relapse of infection.
Decompression ; Drainage ; Empyema ; Empyema, Tuberculous* ; Humans ; Pleural Cavity ; Recurrence ; Thoracostomy ; Tuberculosis, Pleural

No abstract available.
Tuberculosis, Pleural*

PURPOSE: To present CT findings of benign mass-like nodular lesions associated with chronic tuberculousempyema. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of nine patients with mass-like lesions associated with chronic tuberculous empyema, which were pathologically (operation=4, US-guided biopsy=3) or clinically (n=2) confirmed as benign lesions. Shape, number, size, presence of calcification and enhancement pattern of mass-like lesions were assessed. RESULTS: In all patients, chest CT showed unilateral calcified pleural thickening, with mass-like nodular lesions. Fluid within the pleural cavity was observed in eight patients. CT findings of mass-like lesions were multiple and nodular (n=9). Calcification was demonstrated within the lesions in four patients. In each case, the size of the largest nodules was 1-3cm in diameter. In contrast, CTshowed mild (n=6) to moderate (n=2) enhancement compared with adjacent muscles. The pathologic results ofmass-like lesions were chronic inflammation (n=3) and necrosis (n=4). CONCLUSION: Benign mass-like lesions associated with chronic tuberculous empyema appeared as multiple nodules varying in size from 1 to 3cm in diamter, with slight enhancement.
Empyema, Tuberculous* ; Humans ; Inflammation ; Muscles ; Necrosis ; Pleural Cavity ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

BACKGROUND: In contrast to tuberculous pleurisy, tuberculous empyema is a chronic active infectious disease of the pleural cavity that is frequently accompanied by cavitary or advanced pulmonary lesions. The condition requires long-term anti-tuberculous medication with external drainage. The clinical features and treatment outcome of tuberculous empyema are unclear despite the high prevalence of tuberculosis in Korea. METHODS: From January 1991 through April 2004, 17 patients diagnosed with tuberculous empyema in Kyungpook National University Hospital were enrolled in this study. Their medical records and chest radiographs were reviewed. RESULTS: Twelve patients(71%) had a history of tuberculosis and six of the 12 patients were under current anti-tuberculous medication. Productive cough, fever, and dyspnea were the main complaints. There was no predominance between the right and left lungs. Nine patients(53%) had far-advanced pulmonary tuberculosis, two(12%) had a cavitary lesion, and seven(41%) had a pyopneumothorax on the chest radiograph. All eight cases in whom the data of pleural fluid WBC differential count was available showed polymorphonuclear leukocyte predominance. Eight patients(47%) had other bacterial infections as well. The overall rates of a positive sputum AFB smear and culture for M. tuberculosis were 71% and 64%, respectively. The positive AFB smear and culture rates for M. tuberculosis from the pleural fluid were 33% and 36%, respectively. Twelve of the 16 patients(75%) were treated successfully. Three underwent additional surgical intervention. Two patients (12%) died during treatment. CONCLUSION: Tuberculous empyema is frequently accompanied by advanced pulmonary lesions, and polymorphonuclear leukocytes are predominant in the pleural fluid. Other accompanying bacterial infections in the pleural cavity are also common in tuberculous empyema patients. Therefore, tuberculous empyema should be considered in differential diagnosis of patients with polymorphonuclear leukocyte-predominant pleural effusion. In addition, more active effort will be needed to achieve a bacteriological diagnosis in the pleural fluid.
Bacterial Infections ; Communicable Diseases ; Cough ; Diagnosis ; Diagnosis, Differential ; Drainage ; Dyspnea ; Empyema ; Empyema, Tuberculous* ; Fever ; Gyeongsangbuk-do ; Humans ; Korea ; Lung ; Medical Records ; Neutrophils ; Pleural Cavity ; Pleural Effusion ; Prevalence ; Radiography, Thoracic ; Sputum ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

A study of 284 patients with tuberculous pleural effusions cytologically diagnosed by smears stained with giemsa common method allowed distinguishing two groups: typical and untypical patients. Typical tuberculous pleural effusions were characterized by the presence of lymphocytes, typical characterized by the presence of lymphocytes, typical Langhans and/or epithelioid cells, typical caseum and other products and a few number of neutrophils. Untypical tuberculous pleural effusions were marked by the preponderance of lymphocytes, the complete degeneration of neutrophil, the presence of macrophages, lipophages, untypical Langhans and epithelioid cells, and of minor but clear caseum and other degeneration elements, no common bacteria on smears. With these criteria, the true of cytodiagnosis in comparison with histophatology was 80%.
Pleural Effusion ; Tuberculosis ; cells

No abstract available.
Stomach Neoplasms* ; Tuberculosis, Pleural*

Tuberculous pleurisy is the most common form of extrapulmonary tuberculosis in Korea. Tuberculous pleurisy presents a diagnostic and therapeutic problem due to the limitations of traditional diagnostic tools. There have been many clinical research works during the past decade. Recent studies have provided new insight into the tuberculous pleurisy, which have a large impact on clinical practice. This review is a general overview of tuberculous pleurisy with a focus on recent findings on the diagnosis and management.
Adenosine Deaminase ; Diagnosis ; Korea ; Pleural Effusion ; Tuberculosis ; Tuberculosis, Pleural*

No abstract available.
Adenosine Deaminase* ; Adenosine* ; Pleural Effusion ; Tuberculosis ; Tuberculosis, Pleural*

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Pleural Effusion*

Malignant neoplasm associated with long-standing pleuritis or empyema is rare but a critical complication. Among 67 cases which were reported in English and Japanese literatures the cause of empyema was considered tobe tuberculosis in 51 cases. The most common malignant disease associated with the long-standing pleural disease was non-Hodgkin lymphoma (NHL), and the majority of the malignant lymphomas were B-cell type. Detection of the malignancy combined with an empyema is difficult, however, chest radiograph or CT may show the evidence of malignant pleural disease. We report a case of pathologically proven T-cell type malignant NHL associated with chronic tuberculous empyema in a 66-year-old male patient.
Aged ; Asian Continental Ancestry Group ; B-Lymphocytes ; Empyema ; Empyema, Tuberculous* ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Male ; Pleural Diseases ; Pleurisy ; Radiography, Thoracic ; T-Lymphocytes* ; Tuberculosis