Elderly Woman With Shortness of Breath

Diagnosis 

Methyl-methacrylate (Lucite) sphere in the right extrapleural space and left pleural effusion. Before the discovery in the 1950s of drugs effective against Mycobacterium tuberculosis, collapse therapy was the mainstream of treatment of pulmonary tuberculosis because it was shown effective in stopping the disease in an individual. In 1881, Carlo Forlanini of Turin, Italy, introduced the use of artificial pneumothorax.1 As the method gained in popularity, many means to create and maintain the collapse were applied: artificial pneumothorax with air refills, phrenic nerve crush, thoracoplasty, and extrapleural plombage. In the latter case, many available materials were used: fat, paraffin wax, bone, gauze sponge, silk, gelatin, rubber balloons, oil and, as in our case, Lucite balls.2 The occurrence of long-term complication of these treatments is debated.2, 3, 4 In any case, many patients remained asymptomatic but for a certain degree of respiratory failure. Since the 1950s, the use of collapse therapy (and plombage) declined steadily. A young physician may not have encountered such a patient in his practice. Our patient eventually died in the pulmonary ward a few days later of respiratory failure.