%0 Journal Article %T ANSWER to A painless chest swelling. %A Panduru Venkata KISHORE %A Luke MATHEW %A Ezatul AZAHARI %A Osama ABOUZEID %J Brunei International Medical Journal %D 2010 %I Ministry of Health, Brunei Darussalam %X (Refer to page 99)Answer: Tubercular cold abscess. The patient¡¯s chest radiography in the panel across showing right upper zone consolidation.Sputum examination were all negative. Bronchoscopyshowed a mass partially obstructingthe anterior segment of right upper lobebronchus. Biopsy revealed multiple multinucleatedgranulomas and Langhans giantcells with areas of caseation and Acid FastBacilli (AFB) on Zeil-Neelsen staining. Thepatient responded to anti-tubercular treatment(ATT).Ten percent of extra-pulmonary tuberculosis(TB) and one to two percent of totalthe cases of TB are musculoskeletal in origin.Out of all the tubercular cold abscesses,tuberculous spondylitis (cold abscess ofspine) is the most common.1 %U http://www.bimjonline.com/DOAJ/Brunei%20Int%20Med%20J%202010%20Volume%206%20Issue%202.htm