Solitary pleural tuberculoma diagnosed by thoracoscopic surgical resection

Sumiya, Ryusuke; Nagasaka, Satoshi; Ikeda, Takeshi; Miyazaki, Hideki T.

doi:10.1093/jscr/rjab408

“…(5) Clinical cure rates of patients in four groups were recorded. (6) The incidence of adverse reactions during treatment was recorded, including skin rash, liver damage (increased alanine transaminase (ALT)), cytopenia (decreased platelets (PLT)), and renal function (increased uric acid (UA)).…”

Section: Observational Indicesmentioning

confidence: 99%

“…The incidence of pulmonary tuberculoma is 0.62%-5.7%. Most patients with pleural tuberculoma have definite tuberculous pleurisy or pulmonary tuberculosis (75%-96%), but a small number of patients have no definite history of tuberculosis and only find the lesions during physical examination (4.0%-25%) [5][6][7]. Patients with tuberculous pleuritis develop pleural tuberculoma even after regular intensive antituberculosis therapy, which is classical HRZE scheme.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study of Different Treatment Methods for Tuberculous Pleuritis Complicated with Pleural Tuberculoma

Chi

¹

2022

Computational and Mathematical Methods in Medicine

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Objective. To compare the clinical efficacy and adverse drug reactions of four different schemes in the treatment of pleural tuberculoma. Methods. A total of 120 patients with pleural tuberculoma admitted to the Tuberculosis Department of our hospital from January 2018 to January 2021 were selected as the research subjects. According to different treatment methods, the patients were divided into four groups, with 30 cases in each group. They were as follows: group A received classical HRZE regimen, group B received HRZE+pleural injection, group C received HZE+rifabutin, and group D received HZE+rifabutin+pleural injection. All patients were treated intensively for 3 months and then consolidated treatment for 6 months according to the patient’s condition. The absorption of lesions in the four groups at different time was compared, and the occurrences of adverse drug reactions and treatment outcomes during treatment were recorded. Results. After 3 months of treatment, compared with groups A, B, and C, the number of significantly absorbed cases and effective cases in group D increased, while the number of invalid cases decreased. However, there was no statistical significance in the absorption of lesions between the four groups ( χ 2 = 8.272 , P = 0.507 ). In addition, pairwise comparison showed no significant difference in the absorption of lesions ( P > 0.05 ). After 9 months of treatment, there was no significant difference in the absorption of lesions among the four groups ( χ 2 = 8.795 , P = 0.185 ), but the absorption of lesions in group D was significantly better than that in group A ( P < 0.05 ). During treatment, the incidence of adverse reactions in the four groups was significantly different ( χ 2 = 8.779 , P = 0.032 ). Pairwise comparison showed that the incidence of adverse reactions in groups C and D was significantly lower than that in group A ( P < 0.05 ). The total treatment course of group A was 9-16 months, and 10 cases (33.33%) still had residual lesions or pleural thickening at the end of treatment. The total course of treatment in group B was 9-12 months, and 7 cases (23.33%) still had residual lesions or pleural thickening at the end of the course of treatment. The total treatment course of group C was 9-16 months, and 8 cases (26.67%) still had residual lesions or pleural thickening at the end of treatment. The total course of treatment in group D was 9-12months, and there were still 2 cases of residual lesions (6.67%) at the end of the course. Conclusions. HZE+rifabutin+pleural injection against tuberculosis therapy has a significant clinical efficacy in the treatment of pleural tuberculoma, which can more effectively improve the clinical symptoms of patients, improve the efficacy, and reduce complications, with a good prognosis, worthy of clinical promotion.

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“…Some patients initially present with unilateral pleurisy, which later progresses to bilateral PTM. This progression usually occurs gradually and subtly after the complete absorption of pleural uid during anti-tuberculosis therapy [3]. However, the exact mechanism by which tuberculous pleurisy transforms into tuberculous pleuroma, as well as the risk factors for the development of PTM, remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…If left untreated, these benign proliferative lesions can grow in size and number, causing signi cant damage to lung function. Some cases of pleural tuberculoma (PTM) even show signs of necrosis and purulence, leading to tuberculous empyema, which requires surgical removal of the lesion [3]. This surgical intervention not only traumatizes the patient but also results in a decreased quality of life and increased healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

Clinical predictive model for identifying high-risk factors in Pleurisy Tuberculoma patients

Gao,

Yang,

Wang

et al. 2024

Preprint

0

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Introduction : Pleurisy tuberculoma(PTM) manifests as a tumor-like lesion in either the parietal or visceral pleura. The majority of PTM cases arise during the management of tuberculous pleural effusion, underscoring a strong association between the two conditions, despite the precise pathogenesis remaining elusive. To explore the high-risk factors for the development of PTM, we constructed a clinical predictive model aimed at providing more powerful clues for PTM treatment. Methods A retrospective study was conducted on patients with PTM or TPE who were treated at Nanjing Chest Hospital and Nanjing Second Hospital between March 2013 and April 2024. The demographic information and clinical characteristics were sorted out, and the model was constructed by logistic regression, lasso regression, and best subset selection. ROC curves, calibration curves, DCA curves, and clinical impact curves were analyzed for all constructed models to determine the final clinical prediction model. In the internal validation, the performance of the selected model was further evaluated. Results The final predictive model incorporated two risk factors associated with PTM development: Ki-67+CD4+T and Ki-67+CD8+T. Despite its limited calibration, the model has a strong discriminating ability (c-statistic = 0.987; 95% confidence interval: 0.969-1.000) and holds significant clinical value (as indicated by DCA analysis, maintaining a high net benefit across a wide threshold range). During internal validation, the model exhibited excellent predictive performance (AUC: 0.98; Accuracy: 0.96; Kappa: 0.93; Sensitivity: 0.95; Specificity: 0.96). Conclusion A predictive model based on two indicators may help clinicians make early predictions of PTM based on laboratory data. The results of this study may motivate healthcare providers to further investigate the immune role of T lymphocytes in PTM individuals, enhancing comprehension of the development of PTM.

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“…FCT is characterized by the formation of single or multiple caverns in the lung tissue with widespread fibrosis and foci of dropouts of different origins and prescription as a background. The most common surgical treatment for this form of TB is lobectomy [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

MicroRNAs as Biomarkers of Active Pulmonary TB Course

Shepelkova

¹

,

Evstifeev

²

,

Тарасов

³

et al. 2023

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The spread of drug-resistant forms of TB dictates the need for surgical treatment in the complex of anti-tuberculosis measures in Russia. Most often, surgical intervention is performed in the case of pulmonary tuberculoma or fibrotic cavitary tuberculosis (FCT). This study is devoted to the search for biomarkers that characterize the course of disease in surgical TB patients. It is assumed that such biomarkers will help the surgeon decide on the timing of the planned operation. A number of serum microRNAs, potential regulators of inflammation and fibrosis in TB, selected on the basis of PCR-Array analysis, were considered as biomarkers. Quantitative real time polymerase chain reaction and receiver operating curves (ROC) were used to verify Array data and to estimate the ability of microRNAs (miRNAs) to discriminate between healthy controls, tuberculoma patients, and FCT patients. The study showed that miR-155, miR-191 and miR-223 were differentially expressed in serum of tuberculoma with “decay” and tuberculoma without “decay” patients. Another combination (miR-26a, miR-191, miR-222 and miR-320) forms a set to differentiate between tuberculoma with “decay” and FCT. Patients with tuberculoma without “decay” diagnosis differ from those with FCT in serum expression of miR-26a, miR-155, miR-191, miR-222 and miR-223. Further investigations are required to evaluate these sets on a larger population so as to set cut-off values that could be applied in laboratory diagnosis.

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Solitary pleural tuberculoma diagnosed by thoracoscopic surgical resection

Cited by 3 publications

References 6 publications

Clinical Study of Different Treatment Methods for Tuberculous Pleuritis Complicated with Pleural Tuberculoma

Clinical Study of Different Treatment Methods for Tuberculous Pleuritis Complicated with Pleural Tuberculoma

Clinical predictive model for identifying high-risk factors in Pleurisy Tuberculoma patients

MicroRNAs as Biomarkers of Active Pulmonary TB Course

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