Why is there a bag of balls in this man’s left lung?

Came across this interesting X-ray the other day.

These are PLOMBAGE balls. From the latin ‘plumbum’, meaning lead.

Great if you can make the diagnosis on the X-ray.

They are a form of treatment prior to the 1960′s for TB. It was believed at that time, that if an inert substance was placed in the pleural cavity and it caused a diseased upper lobe to collapse, it would lead to earlier healing. There were several types of inert substances initially used, including olive oil and gauze, lucite balls, a type of acrylic and plastic ping-pong balls. There were complications including infection, that began to make the procedure less popular. With the increased use and effectiveness of anti-TB medications, the procedure was ceased.

The initial concept came from Italy in the 1800′s where air was injected into the pleural space to collapse the lung. This was also associated with phrenicolysis; the crushing or division of the phrenic nerve, resulting in ipsilateral paralysis of the diaphragm.