CTICasesTuberculous Chest Wall Abscess / Empyema Necessitans
Imaging findings
Prior radiographs from 2012 show consolidation in the right upper lobe and a quiescent pleural process. Current imaging reveals a new mass in the chest wall, with a fluid collection that is continuous with an underlying pleural abnormality. The right upper lobe granuloma remains largely unchanged.
Key takeaways
Reactivation of latent tuberculosis can lead to a chest wall abscess, often extending from an adjacent pleural focus. This entity, sometimes colloquially referred to as 'empiema necessitans' (though the term is debated if there is no active external drainage), is confirmed by identifying Mycobacterium tuberculosis via PCR from the abscess fluid. This highlights the potential for late recurrence of TB with atypical extrapulmonary manifestations.
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