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Chest clinic
Images in Thorax
Oleothorax
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  1. Till Plönes,
  2. Clemens Aigner
  1. Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany
  1. Correspondence to Dr Till Plönes, Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital, University of Duisburg-Essen, Essen D-40539, Germany; till.ploenes{at}rlk.uk-essen.de

http://dx.doi.org/10.1136/thoraxjnl-2017-210544

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    We report the case of an afebrile 85-year-old patient with progressive swelling of the right hemithorax (figure 1A). The patient was previously treated in the early 1950s for pulmonary tuberculosis with plombage therapy using extrapleural injection of paraffin oil. A CT revealed an extrathoracic leak of oleothorax (figure 1B). Intraoperative findings showed a calcified chest cavity with extrathoracic expansion of yellow oily fluid (figure 2A–C). Following exclusion of infection, treatment consisted of the temporary application of negative intrapleural pressure with subsequent intrathoracic transposition of the latissimus dorsi muscle. 

    Figure 1
    Figure 1

    (A) Progressive swelling of the right hemithorax; (B) CT of the chest showing the oleothorax with pleural calcifications (marked by asterisk (*)) and the extrathoracic collection of fluid (marked by an arrow). The intracavitary fluid has different densities.

    Figure 2
    Figure 2

    Intraoperative findings: (A) calcified chest cavity; (B) intrathoracic collected yellow oily fluid ; (C) resected extrathoracic capsule intrathoracic collected yellow oily fluid.

    Footnotes

    • Contributors TP wrote the MS. CA supervised the work.

    • Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.