With a single diagnostic puncture 80 ml protein-rich fluid could be immediately evacuated. A pneumothorax could be evacuated immediately via the thin needle.
Dense (perhaps fibrinous) fluid remained on the surface of both pleurae.

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therapy empyema

The state after puncture has slightly improved; it remained unchanged in a x-ray-control eight weeks later.

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result persist effusion

Let’s repeat the complications:
before this 59-year-old man  died of metastatic rectal carcinoma, a wide pleural shadow has been confirmed. It was  the remnant of right-sited empyema 19 years earlier and had always been described as calcified fibrothorax  despite pronounced fever and coughing beginning 4 years prior to his death.
The correct diagnosis is: persistent effusion between the partially calcified pleural layers. A pleurobronchial fistula developed, resulting in replacement of the contents of the cavity by air, so that it now appears more radiolucent than the neighbouring lung.

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pleuro-bronchial fistula
What do the parallel horizontal lines, numbered 1-3 really indicate?
(Click here for the answer)

The parallel horizontal line indicates the non calcified fatty layer between the parietal pleura and the inner chest wall. The numbers indicate the pleurae:
1 = parietal;
2 = visceral pleura;
3 = dorsal connection between the two pleural layers.

The ribs on the affected side are enlarged (12 mm in the mid-axillary region in comparison to 8 mm on the opposite side).

Another complication: chronical empyema complicated with a pleuro-dermal  fistula.

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pleuro-cutan fistula
What kind of procedure has been performed? What has been demonstrated?
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Filling of the fistula with contrast medium; it demonstrates the connection with the pleural cavity.

In another case pleural empyema became reactivated, broke through the chest wall and caused a massive infiltration in the soft tissue and skin.

empyema necessitatis
What is this condition called? A new and very interesting paper is: CT Manifestations of Late Sequelae in Patients with Tuberculous Pleuritis Jung-Ah Choi1, Ki Taek Hong1,AJR 2001; 176:441-445 (Click here for the answer)