目的　探讨胸膜结核球临床及X线特点。方法　分析 1 970～ 1 998年收治的 3 1例胸膜结核球。结果　 1 1 9例既往有明确的渗出性胸腔积液史 ( 61 3 % ) ,经治疗胸水吸收 ,数月至数年后发现球形病灶。2 2 4例正侧位胸片有不同程度的胸膜增厚、钙化及肋膈角改变 ( 77 4 % )。 3 本组误诊为肺癌、胸膜间皮细胞瘤及错构瘤等占 4 5 2 % ( 1 4 / 3 1 )。结论　胸膜结核球结合完整的病史 ;依靠切线位片、CT及胸部透视即可诊断。经积极的抗结核治疗可避免手术。 Objective To investigate the clinical and X-ray features of pleural tuberculosis. Methods 31 cases of pleural tuberculoma treated from 1970 to 1998 were analyzed. Results A total of 119 cases of exudative pleural effusion (61.3%) were previously treated with pleural effusion. Spherical lesions were found after months and years. There were 24 cases of pleural thickening, calcification and costophrenic angle (77 4%). 3 This group misdiagnosed as lung cancer, pleural mesothelioma and hamartoma accounted for 452% (14/31). Conclusion pleural tuberculosis combined with a complete history of the disease; relying on the tangent slice, CT and chest fluoroscopy can be diagnosed. Active anti-TB treatment avoids surgery.