CTICasesCalcified Fibrothorax from Historical Tuberculosis Collapse Therapy
Imaging findings
Chest radiograph and chest CT show extensive, dense, sheet-like pleural calcification encasing the hemithorax, characteristic of a chronic calcified fibrothorax. An adjacent well-defined extrapleural collection is present. While oleothorax (historical treatment with paraffin or beeswax) typically demonstrates low attenuation, this collection demonstrates higher attenuation, representing chronic hematoma, fluid, or localized scarring resulting from historical collapse therapy for tuberculosis.
Key takeaways
Calcified fibrothorax is a late, chronic sequela of tuberculous pleurisy, empyema, or hemothorax. Historically, tuberculosis was treated using active collapse therapies designed to collapse diseased lung tissue, including artificial pneumothorax, thoracoplasty, and oleothorax. Recognizing these calcified pleural and extrapleural patterns is critical for identifying historical sequelae of tuberculosis treatment and differentiating them from active pleural neoplasms or infectious processes.
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