Abstract
Sternal osteomyelitis due to tuberculosis (TB) is a clinical rarity that accounts 1-3% of all cases of osteoarticular TB.Patients are often relatively young and have no co-morbidity. Common symptoms and signs are local swelling,pain and a discharging sinus tract.Diagnosis is difficult and is often delayed because of atypic presantation and lack of awareness.The magnetic resonance imaging(MRI) may be useful in the early stages and in atypical presentations.
A 23 year-old female admitted with a 6-months history of chest pain and mass on middle sternal part of her chest.Physical examination and chest x-ray were normal.Laboratory findings were unremarkable.A computerized tomography ( CT ) of the thorax and MRI showed a 33x28x42 mm soft tissue mass that was eroding the corpus sternum.In the CT scan, no pathological findings in the pulmonary parenchyma,pleura and lymp nodes were detected.Deep biopsy samples from lesions were obtained . Pathology revealed multiple granulomatous and necrotic lesions consistent with tuberculous osteomyelitis. Our patient had no underlying risk factors and no immunosupressive diseases.There was no a history of tuberculosis.
The possibillity of sternal TB should be kept in mind in the differential diagnosis of a mass involving the chest wall,particularly in endemic areas.Herein, we report a case of a sternal mass mimicking a chest wall tumor and finally diagnosed as primary sternal tuberculosis .
- Copyright ©ERS 2015
