[Tuberculous lesions of the pleura]

Tuberculous involvement of the pleura became quite incident of late. Eighty-seven patients with this condition were hospitalized at the phthisiosurgery department of the Kostroma District Antituberculosis Center in 1985-1992. Tuberculous pleurisy was diagnosed in 30 patients, in 29 pleurisy was a complication of pulmonary tuberculosis (in 13 cases of infiltrative tuberculosis, in 12 of focal, in 3 of disseminated, and in 1 of cirrhotic pulmonary tuberculosis), in 8 patients acute tuberculous pleural empyema was diagnosed which developed in the presence of infiltrative and cirrhotic pulmonary tuberculosis, and in 18 cases chronic tuberculous pleural empyema with calcification was found. Two patients were operated on for pleural tuberculomas. Tuberculous pleurisy can be completely cured with drugs and therefore presents not a therapeutic but a diagnostic problem. In intricate cases wider use of invasive methods of examination may be recommended, such as puncture biopsy of the pleura, thoracoscopy with spot biopsy of the pleura, open biopsy of the pleura, and biopsy of peristernal lymph nodes.