CTICasesTuberculosis with Empyema Necessitans
Imaging findings
Chest CT and MRI show a large, necrotic anterior mediastinal mass with direct extension and dissection through the anterior chest wall into the subcutaneous tissues. Abdominal CT demonstrates multiple small, low-attenuation microabscesses scattered throughout the spleen.
Key takeaways
Empyema necessitans is a rare complication in which an infectious collection, most commonly tuberculous, dissects through the parietal pleura or mediastinum into the chest wall. This presentation can mimic lymphoma or a primary chest wall sarcoma, highlighting the importance of considering infectious etiologies in high-risk patients or those returning from endemic areas.
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