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

Background: Empyema is not rare in Vietnam and in the world. Objective: To study clinical, subclinical manifestations and lung CT-scan images of patients with empyema. Subjects and method: A study included 50 patients of empyema treated in Department of Respiratory of Bach Mai Hospital, from January 2003 to August 2005. This was a retrospective, prospective, descriptive, cross-sectional, controlled study. Results and conclusions: Most empyema commonly occurred in the setting of bacterial pneumonia. Empyema was common in males and the male-to-female ratio was 2.82. The onset of empyema was suddenly with clearly infection syndrome (high fever, increased WBC count, accelerated erythrocyte sedimentation rate), chest pain, and cough. CT images of empyema were ipsilateral; almost empyema was free pleural effusion and moderate in size. Thickening pleura was 72% and located pleura were 42%. Positive culture of pleural fluid was very low (24%). Gram (-) bacteria was predominant (P. Aeruginosa 33.3%, K. Pneumoniae 25%).
Empyema ; Pleural/diagnosis ; radiography

PURPOSE: To assess the utility of 2-[18F] fluoro-2-deoxy-D-glucose (FDG) PET in differentiating malignant and benign diffuse pleural disease, and to compare it with CT. MATERIALS AND METHODS: Both FDG PET and CT scans were performed in 20 consecutive patients with diffuse pleural disease (13 malignant and seven benign cases). In FDG PET, peak standardized uptake value (SUV) as well as visual assessment of abnormally increased uptake in the pleura was evaluated. The results were compared with CT findings. RESULTS: With only visual assessment of PET images, sensitivity, specificity, and accuracy for malignancy were 92%, 43%, and 75%, respectively. With peak SUV of 4.8 or more, the corresponding figures were 100%, 57%, and 85%, respectively, and on CT interpretation, were100%, 57%, and 85%, respectively. Tuberculous empyema simulated malignant pleural disease both on FDG PET (3/6 patients with peak SUV more than 4.8) and CT (3/6 patients). CONCLUSION: For the differentiation of malignant and benign diffuse pleural disease, FDG PET and CT are equally accurate. Combined visual and quantitative assessments of PET images enhance discriminatory ability. Tuberculous empyema simulates malignant pleural disease both on FDG PET and CT.
Diagnosis, Differential* ; Empyema, Tuberculous ; Fluorine ; Humans ; Pleura ; Pleural Diseases* ; Sensitivity and Specificity ; Tomography, X-Ray Computed

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

Chronic empyema thoracis results from various etiologies. Improvement in pulmonary function after empyemectomy and decortication has proved difficult to predict when the etiology of chronic empyema thoracis is tuberculosis. The purpose of this study was to confirm the changes in pulmonary function according to the etiology after an operation. Sixty-five patients were classified into two groups according to their etiology: Group A (tuberculous) and Group B (non-tuberculous), and they were retrospectively evaluated with regard to their forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), percentage of predicted normal value of FEV1 (% FEV1) and FVC (%FVC). Empyemectomy and decortication was performed for all the patients and the two groups were similar in age, gender and preoperative spirometric parameters. In Group A (n=41), the pre- and postoperative mean values were 2.31L and 2.88L in FEV1, 65.8% and 80.5% in %FEV1, 2.62L and 2.55 L in VC, 61.9% and 71.8% in %VC, respectively. In Group B (n=24), the pre- and postoperative mean values were 2.13L and 2.49L in FEV1, 66.4% and 73.8% in %FEV1, 2.55L and 2.95 L in FVC, 64.9% and 71.8% in %FVC, respectively. All the spirometric parameters improved significantly in both groups compared to their preoperative values. However, no significance was shown in the rate of increase of the spirometric parameters between the two groups. In conclusion, improvement of lung function is expected after empyemectomy and decortication, regardless of the etiology of the chronic empyema thoracis.
Adult ; Chronic Disease ; Comparative Study ; Debridement ; Empyema, Pleural/physiopathology/surgery ; Empyema, Tuberculous/*physiopathology/*surgery ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vital Capacity

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

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

Pleural involvement in paragonimiasis is relatively common, either unilateral or bilateral, and may occur without pulmonary parenchymal infiltrates. Common radiologic findings of pleural paragonimiasis are pleural effusion, pneumothorax, hydropneumothorax, empyema and pleural thickening. However, pleural calcification as a manifestation of paragonimiasis is a rare condition. We report two cases of paragonimiasis manifested only as pleural calcifications which were confirmed pathologically.
Empyema ; Hydropneumothorax ; Paragonimiasis* ; Pleural Effusion ; Pneumothorax

No abstract available.
Empyema*

No abstract available.
Empyema*