CXR Case 043

There is bilateral apical pleural calcification, more pronounced on the right.
There is additional right upper lobe fibrosis and traction causing the right hilum to be elevated, mediastinal shift and volume loss on the right side.

This lady has old Right upper lobe (RUL) and pleural TB.

She will likely have chronic airways limitation due from the architectural distortion.

Bilateral apical pleural calcification like this is highly likely old TB.

Unilateral apical calcification is most likely TB, although previous haemothorax or empyema are other causes.
Asbestos related pleural plaque does not affect the apicies.