Parietal Thoracic Tuberculosis in the Immunocompetent

Introduction: parietal thoracic tuberculosis is a rare entity. It represents less than 0.1% of all forms of tuberculosis. It often poses a problem of differential diagnosis with parietal tumors, especially in the absence of other pulmonary or extra-pulmonary lesions suggestive of tuberculosis. Observation: A 28-year-old patient, with no particular pathological history, consulted for a right basithoracic swelling evolving for a month of firm consistency, without any local inflammatory signs. The thoracic ultrasound showed an echogenic fusiform subcutaneous tissue formation infiltrating the 9th rib without costal lysis. The thoracic CT scan revealed a mass of heterogeneous density at the level of the 8th intercostal space with bilateral upper lobar pulmonary nodules. The intradermal tuberculin reaction was positive. Histological examination of the transparietal biopsy puncture made it possible to diagnose thoracic parietal tuberculosis by showing the presence of a granulomatous tuberculoid inflammation with suppurative necrosis; and a bacteriological examination of the bronchial suction fluid confirmed the existence of a second pulmonary localization. It should be noted that the HIV, hepatitis B and C serologies were negative. Discussion: Tuberculosis of the thoracic wall remains an unusual location of tuberculosis. Its frequency is estimated between 1 and 5% of osteoarticular tuberculosis which constitutes less than 15% of extra-pulmonary tuberculosis. The search for other tuberculosis locations is a necessary step in the diagnostic process.