CTICasesMilk of Calcium in the Pleural Space
Imaging findings
Chest radiograph shows a very opaque right hemithorax in the basal right pleural space. CT reveals extensive and very attenuating pleural membrane calcifications, more pronounced on the right. This appearance is consistent with milk of calcium. Associated findings include possible asbestos plaques on the left hemidiaphragm and mild atelectasis in the right lung base.
Key takeaways
Milk of calcium within the pleural space is a rare finding, characterized by highly attenuating, dependent fluid-like material due to suspended calcium precipitates, often in the setting of chronic pleurisy, such as from tuberculosis. It can mimic a fluid level on CT and present as an opaque hemithorax on plain radiographs. Despite its impressive appearance, it may be asymptomatic, and attempts to drain it may yield little fluid.
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