Question 881
{"accessible":true,"alternatives":[{"id":4430,"text":"calcified hemothorax"},{"id":4431,"text":"empyema"},{"id":4432,"text":"mesothelioma"},{"id":4433,"text":"oleothorax"},{"id":4434,"text":"pleural plaque"}],"archived":false,"correctAlternativeId":4433,"explanation":"\u003cp\u003e\u003ca href=\"/articles/oleothorax\"\u003eOleothorax\u003c/a\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eis a historical treatment method for cavitary\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/tuberculosis\"\u003etuberculosis\u003c/a\u003e\u0026nbsp;of the upper lobes of the\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/lung\"\u003elungs\u003c/a\u003e. It was used prior to the introduction of effective antituberculous drugs and thus was generally discontinued after the 1950s. The technique involved\u0026nbsp;intra- or extrapleural injection of oil in order to either collapse an upper lobe affected by TB,\u0026nbsp;control\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/bronchopleural-fistula\"\u003ebronchopleural fistulas\u003c/a\u003e,\u0026nbsp;prevent persistent tuberculous\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/empyema-1\"\u003eempyema\u003c/a\u003e, or prevent recurrent tuberculous\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/pneumothorax\"\u003epneumothorax\u003c/a\u003e.\u0026nbsp;Usually, the oil was removed after ~2 years, however, many asymptomatic patients were lost to follow-up and never had the oil removed. These patients lost to follow-up, now elderly, often have the oleothorax noted incidentally on plain radiograph, where it is seen as a large dense apical lentiform calcified opacity in the upper zones\u0026nbsp;with accompanying pleural thickening.\u003c/p\u003e\u003cp\u003eThe appearance has a differential diagnosis of an old calcified\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/empyema-1\"\u003eempyema\u003c/a\u003e,\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/haemothorax\"\u003ehemothorax\u003c/a\u003e\u0026nbsp;with calcification, or\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/mesothelioma\"\u003emesothelioma\u003c/a\u003e\u0026nbsp;and other pleural lesions, however, the provided clinical history and typical appearance and location of this lesion is classical for \u003ca href=\"/articles/oleothorax\"\u003eoleothorax\u003c/a\u003e.\u003c/p\u003e","id":881,"imageUrl":"https://prod-images-static.radiopaedia.org/images/30851392/25151b82f815e2222404041fbd69cd_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":53909},"imageAttributionCaseInfo":{"title":"Oleothorax","contributor_name":"Eric F Greif","contributor_param":"egreif","case_rid":53909,"case_param":"oleothorax"},"firstQuestionPath":"/questions/881","nextQuestionPath":null,"relatedArticles":[{"id":8712,"title":"Mesothelioma","link":"/articles/mesothelioma?lang=us"},{"id":24341,"title":"Hemothorax","link":"/articles/haemothorax?lang=us"},{"id":8740,"title":"Hairy pleural plaque","link":"/articles/hairy-pleural-plaque-1?lang=us"},{"id":7336,"title":"Pleural empyema","link":"/articles/pleural-empyema-1?lang=us"},{"id":8631,"title":"Tuberculosis (pulmonary manifestations)","link":"/articles/tuberculosis-pulmonary-manifestations-1?lang=us"},{"id":52148,"title":"Oleothorax","link":"/articles/oleothorax?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eWhat is seen in the right upper zone in this\u0026nbsp;90-year-old patient who has a past medical history remarkable for tuberculosis\u0026nbsp;that was treated over 70 years ago?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/881"}],"attemptsPercentages":[{"alternativeId":"4430","percentage":18},{"alternativeId":"4433","percentage":38},{"alternativeId":"4432","percentage":7},{"alternativeId":"4431","percentage":7},{"alternativeId":"4434","percentage":29}],"promptToLogin":false,"questionManager":false,"articleId":"pleural-plaque"}