A 68-year-old female smoker is seen in the ER due to mild hemoptysis and cough with 1 to 2 teaspoons of light-green sputum production in the A.M. She uses inhalers as needed for occasional shoness of breath. A routine chest x-ray is obtained.The abnormality seen on the CXR is most likely due to

There is a large, opaque, calcified pleural-based chest wall opacity in the left upper thorax with distoion of the left thoracic cage. The upper left ribs are abnormal and the chest wall is depressed. These changes are a sequela to lung collapse therapy with thoracoplasty Thoracoplasty is the excision of substantial segments of the bony thorax to reduce its size. The indication for thoracoplasty in this case was unilateral cavitary pulmonary tuberculosis that had not responded to other forms of treatment. Occasionally, thoracoplasty is still done to obliterate empyema cavities. Following thoracoplasty, large tuberculous cavities heal by organization of granulation tissue and the contracted tissue becomes encased in a thick pleural membrane. Associated pleural calcification and thickening are seen.