Case 1
History
57 year old male with history of pulmonary tuberculosis.
PA chest radiograph shows multiple thin walled cystic
spaces of equal size and wall thickness.
CT of the chest showing marked volume loss in the left
hemithorax with multiple spherical lucencies.
Findings
PA chest radiograph shows multiple thin walled cystic spaces of equal size and wall thickness.
Chest X ray of a patient with history of TB treated by Pulmonary Plombage technique. Many of these patients who have undergone one of the many varieties of "Plombage" surgery are being radiographed. All of the operations involve extrapleural stripping of the tissues and insertion of an inert substance into the space created.
This was usually a plastic material and the three most common forms were solid plastic spheres, hollow Ping-Pong balls, or packs of crumpled cellophane.
The Lucite spheres produce an opacity showing some circular diminutions in density due to the lower radio-opacity of the plastic material. The Ping-Pong balls result in a peculiar appearance suggestive of multiple cavities often enhanced by the fluid levels where they have cracked and admitted fluid from the tissues. The symmetry and regularity of the cavities should make recognition easy.
