Q: CXR finding of tuberculous pleural effusions is mostly?

A) Bilateral and small to moderate
B) Tend to be unilateral on left and large
C) Tend to be unilateral on right and small to moderate
D) Loculated on right upper
E) Loculated on left upper



Answer:  C

Interestingly, 2 studies 1,2 looked into this 5 decades apart and found that tuberculous pleural effusions are mostly unilateral and tends to occur on the right side. Effusions are usually small to moderate - and famously quote to occupy less than one-third of the hemithorax. On side note, Tuberculous pleurisy is more common in AIDS than in non-AIDS patients 3.


References:


1. SIBLEY JC. A study of 200 cases of tuberculous pleurisy with effusion. Am Rev Tuberc 1950; 62:314.

2. Valdés L, Alvarez D, San José E, et al. Tuberculous pleurisy: a study of 254 patients. Arch Intern Med 1998; 158:2017. Frye MD, Pozsik CJ, Sahn SA. 

3. Tuberculous pleurisy is more common in AIDS than in non-AIDS patients with tuberculosis. Chest 1997; 112:393.