Sternal cold abscess - tuberculosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Midline painful swelling of the anterior chest wall with a cough and intermittent fever.

Patient Data

Age: 15 years
Gender: Female

There is an osteolytic sternal lesion with surrounding collection of fluid density with peripheral enhancement, extending to the retrosternal space, anterior to the left innominate vein. Multiple lymphadenopathies with central necrosis are seen in the right hilum, right paratracheal region, carinal and subcarinal spaces. The lung window shows centrilobular nodular opacities with "tree-in-bud" pattern involving the right lower lobe mainly the superior and mediobasal segments.

Case Discussion

CT appearances were highly suggestive a sternal cold abscess in a patient with changes consistent with lung tuberculosis and mediastinal lymphadenopathy.

FNA cytology of the sternal cold abscess was performed and tuberculous origin was confirmed.

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