ArticleJournal of cardiothoracic surgery2026
Thoracoscopic diagnosis of tuberculous pleuritis mimicking pleural malignancy with chest wall involvement: a challenging case report.
Article in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTuberculous pleuritis is a common form of extrapulmonary tuberculosis that may closely mimic pleural malignancy, particularly when associated with loculated effusion, pleural thickening, or chest wall involvement. This diagnostic challenge is amplified in resource-limited settings. CASE PRESENTATION: We report a 41-year-old male with a 30 pack-year smoking history who presented with a two-month history of pleuritic chest pain, dyspnea, night sweats, and significant weight loss. Imaging revealed a large loculated right-sided pleural effusion with diffuse pleural thickening and associated rib destruction, raising strong suspicion for pleural malignancy. Thoracentesis demonstrated a lymphocyte-predominant exudative effusion. Due to limited diagnostic resources, advanced microbiological investigations were unavailable. The patient underwent video-assisted thoracoscopic surgery (VATS), which revealed diffusely thickened pleura with multiple whitish plaques. Histopathological examination revealed caseating granulomatous inflammation consistent with tuberculous pleuritis. The patient responded well to anti-tuberculous therapy.
conclusionsTuberculous pleuritis can mimic pleural malignancy, particularly in the presence of chest wall involvement. Thoracoscopic pleural biopsy remains a highly valuable diagnostic tool in cases where non-invasive investigations are inconclusive or unavailable.
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