[So-called "open healing" of chronic calcified pleural empyema--a study on the etiological and clinical problems]

Surgery performed on a 70 year-old male revealed a case of chronic calcified pleural empyema open healing that was induced through an effective bronchiolar drainage mechanism. The patient had previously received anti-tuberculosis medication, including INH and RFP, 7 years prior for positive sputum cultures and symptoms of fistulation observed in an x-ray finding of right lung pleural calcification. The four cardinal signs of chronic calcified pleural empyema open healing are as follows: 1. Failure to isolate tubercle bacilli, 2. Inability to locate necrotic coagulation or specific inflammatory granulation tissue on the cavitary wall, 3. Calcified pleural plaque detached from the cavitary wall, and 4. Microscopic recognition of many drainage bronchiolar openings to the empyema and the inner surface of the empyema covered with stratified squamous epithelium, which possibly penetrated via the entering bronchioles.