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Cutaneous tumefaction in empyema necessitatis.

Cesar V Reyes¹

¹Cytology Section, Veterans Affairs Hospital, Hines, and Department of Pathology, Morris Hospital, Morris, IL, USA. creyes@morrishospital.org

International Journal of Dermatology

|January 5, 2008

Summary

Empyema necessitatis, a chest wall mass, can be diagnosed using fine-needle aspiration biopsy (FNAB). This method proved useful in identifying various causes, including tuberculosis and malignancy.

Area of Science:

Pulmonology
Thoracic Surgery
Diagnostic Pathology

Background:

Empyema necessitatis is a rare complication involving pleural fluid extending to the chest wall, historically linked to tuberculosis and other infections or malignancies.
It presents as an extrapleural soft tissue mass originating from the pleural cavity.

Observation:

This study reports on seven cases of chest wall mass lesions diagnosed as empyema necessitatis.
Diagnosis was established using fine-needle aspiration biopsy (FNAB).

Findings:

The etiologies identified included tuberculosis (3 cases), mesothelioma (2 cases), small cell lung carcinoma (1 case), and a co-infection of Actinomyces and Actinobacillus (1 case).
Pleural fluid cytology confirmed empyema and the specific causative agents in all instances.

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Implications:

Fine-needle aspiration biopsy (FNAB) is a valuable tool for diagnosing empyema necessitatis.
Combined with imaging and other tests, FNAB aids in identifying the diverse underlying causes of this condition.