结核性脓胸（TuberculousEmpyema）通常是指胸膜腔被结核分枝杆菌感染，发生干酪样坏死而积脓的病理状态，有时可合并其他细菌感染，与普通的结核性胸膜炎不同。胸膜腔结核分枝杆菌的感染多由于肺结核空洞或胸膜下干酪样病灶破裂进入胸膜腔所致；此外，肺门淋巴结的结核病变中结核分枝杆菌可逆流至胸膜腔致病；急性或亚急性血行播散性结核灶播散至胸膜腔，可引起多浆膜腔积液。邻近组织的化脓性感染病灶，如纵隔脓肿、膈下脓肿或肝脓肿等，致病菌可经淋巴组织或直接穿破侵入胸膜腔，引起单侧或双侧胸膜腔的混合感染。
Tuberculouspyothorax(tuberculousempyema)usuallyreferstothepleuralcavitybymycobacteriumtuberculosisinfection,caseousnecrosisandempyemapathologicalstate,sometimescanmergewithotherbacterialinfections,differentfromordinarytuberculouspleurisy.Pleuralcavityofmycobacteriumtuberculosisinfectionduetopulmonarytuberculosiscavityorsubpleuralcaseatinglesionscausedbyburstintopleuralcavity;Inaddition,thedooroflymphnodetuberculosisofthelunginmycobacteriumtuberculosiscanflowtopleuraldisease;Acuteorsubacutebloodlinedisseminatedtuberculosisstovespreadtothepleuralcavity,canleadtomoreserouscavityeffusion.Adjacenttissueofsuppurativeinfectionlesions,suchasmediastinalabscess,diaphragmaticabscessorliverabscess,pathogenicbacteriacanbeinvadedbythelymphoidtissueorwearoutdirectlypleuralcavity,unilateralorbilateralpleuralcavityofmixedinfection.
结核性脓胸的X线表现与慢性脓胸基本类似，可表现为患侧胸腔积液及胸膜粘连、肥厚等征像，多为包裹性积液，如患侧肺内有结核病灶往往被积液所掩盖，而不易确定胸腔积液的性质。慢性者可见患侧胸膜明显肥厚、钙化及胸膜塌陷、肋间隙变窄、纵隔向患侧移位等表现。
TuberculouspyothoraxsimilarX-raymanifestationsandchronicpyothorax,greenperformancesidepleuraleffusionandpleuraladhesion,hypertrophy,etc.),moreforparceleffusion,suchassideinpulmonarytuberculosiskitchenoftenconcealedbyeffusion,andnoteasytodeterminethenatureofthepleuraleffusion.Chronicvisiblelateralpleurahypertrophy,calcificationandpleuralcollapsetooneside,ribgapNarrows,mediastinalshift,etc.
CT扫描可以对胸腔积液进行准确的定位、定量诊断，但在结核性脓胸的定性诊断上亦缺乏特异性，需结合临床和肺部病变进行综合判断。有文献报道，肺结核新患者中约4.7%-17.6%可发生胸膜积液，因此当CT发现典型的胸膜下肺结核病变时，如结核空洞伴周围结节及浸润性病灶，则可支持结核性脓胸的诊断。
CTscancanaccuratepositioningandquantitativediagnosisofpleuraleffusion,butalsoonthequalitativediagnosisoftuberculouspyothoraxlackofspecificity,andoveralljudgmentshouldbecarriedout白癜风怎么诊断症狀北京治疗白癜风医院哪里最好
