Thoracic plombage

Case contributed by Dr Jan Frank Gerstenmaier

Presentation

This patient presented to the ED with collapse. A chest radiograph was carried out along other tests in the workup of collapse, which eventually was found due to a cardiac arrythmia.

Patient Data

Age: 80
Gender: Female

Chest radiograph

Modality: X-ray

There is volume loss in the left hemithorax. Several rounded ring shadows are seen in the left upper zone, with intervening radiopaque material. There is left upper chest deformity with several ribs missing or fractured. Calcified hilar lymph nodes are evident.

CT chest

Modality: CT

Ed physicians were puzzled by the appearances on chest radiograph

Appearances are consistent with left apical plombage for the treatment of tuberculosis.

Case Discussion

Plombage is a historical treatment for tuberculosis by means of creating lobar collapse. Plombage was carried out until the mid 1950s, so in practice this is expected to be encountered for some years to come.

In this case, the finding of plombage was purely incidental, but was further investigated with CT because of lack of prior imaging, and because of unfamiliarity with the radiographic appearances.

Example from the literature of Lucite-ball plombage excised post-mortem1

Related article: PlombageMedical Devices in the ThoraxTuberculosis

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Case Information

rID: 21981
Case created: 2nd Mar 2013
Last edited: 21st Oct 2016
System: Chest
Inclusion in quiz mode: Included

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