Here is a fibrous cast, stripped from the lung and chest wall, showing on the outer surface rib
impressions. The fibrous tissue is thick, and the cavity apparent is lined by grumous material, in
which there has probably been some bleeding.
This man was treated for pulmonary tuberculosis in the late 1940's; later he developed
pulmonary hydatid disease, and had a left thoracotomy, with excision of two hydatids from the left
lung in 1964.
In 1970, he developed right pleurisy, which went on to an effusion and an empyema. This lesion
was considered to be tuberculous, and treated as such, but it did not improve satisfactorily. In 1976,
he began to cough up dark blood-stained material, and he was treated further with anti-tuberculous
drugs. No tubercle bacilli were found, but there seems little doubt that the lesion was tuberculous
initially. The empyema cavity was excised.