Extrathoracic communication of persistent pulmonary tuberculous pneumatocele.

tocele in the left upper lobe. A linear air pocket in the soft tissue of the left upper hemithorax was also noted ( fig. 1 c). CT revealed a 15 ! 6 cm cavitary lesion in the left upper lobe extending and communicating with the chest wall through a fistulous tract without pneumothorax or mediastinal emphysema ( fig. 2 ). The subcutaneous air pocket had been noted on the patient’s examination 4 years prior ( fig. 1 a). It had gradually decreased with antituberA 33-year-old man presented with a productive cough. Four years earlier, we had treated the same patient for pulmonary multidrug-resistant tuberculosis for only 12 months, after which he became lost to follow-up. The patient’s sputum smears were positive for acid fast bacilli. Chest radiography showed apical cavitary consolidation in the right upper lobe, extensive opacification due to pleural effusion in the left lower lobe and a large pneumaPublished online: November 5, 2010