Oleothorax is a historical treatment method for cavitary tuberculosis of the upper lobes of the lungs. It was used prior to the introduction of effective antituberculous drugs and thus was generally discontinued after the 1950s.
Oleothorax is an intra- or extrapleural injection of oil, usually paraffin oil, with the intent to either cause collapse of an upper lobe (theoretically promoting healing), to control bronchopleural fistulas, to prevent persistent tuberculous empyema, or to prevent recurrent tuberculous pneumothorax . Occasionally, gomenol was added to the paraffin oil for anti-bacterial activity . Usually, the oil was removed after 18-24 months, however, many asymptomatic patients were lost to follow-up and never had the oil removed .
Possible complications can occur after many years, including expansion of the oleothorax causing respiratory distress, rupture of the oleothorax causing paraffin oil aspiration, bronchopleural fistula, and super-imposed infection (including empyema) .
Oleothorax is often noted incidentally, and are described as large dense apical lentiform calcified opacities with accompanied pleural thickening seen on plain chest radiograph . The appearance has a differential diagnosis of an old calcified empyema, hemothorax with calcification, or mesothelioma and other pleural lesions .