CTICasesLucite Sphere Plombage Therapy for Tuberculosis
Imaging findings
Chest radiograph and CT demonstrate multiple, well-circumscribed, hollow, spherical foreign bodies packed tightly within the extrapleural space of the upper hemithorax, consistent with lucite spheres. One of the medial spheres shows a faint internal fluid level, highly suspicious for localized infection or fistulization.
Key takeaways
Plombage is an obsolete collapse therapy historically used to treat cavitary pulmonary tuberculosis prior to the advent of effective antituberculous chemotherapy, designed to compress the lung apex and create an anaerobic environment hostile to mycobacteria. Lucite (polymethyl methacrylate) spheres, paraffin, or beeswax were commonly used. Complications of plombage include late-onset infections, migration, hemorrhage, and bronchopleural or cutaneous fistulization, which may manifest as fluid levels within the previously hollow spheres.
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