A 91 years old female presented with chest pain and shortness of breath after a fall. Chest radiograph showed a very large left-sided fluid collection surrounded by calcified pleura and collapse of the left lung. CT scan of chest with contrast revealed a chronic appearing increased density left pleural effusion contained within thick calcified pleura. Upon further questioning patient reported that when she was 20 years old she had repeated punctures to her left chest to collapse the lung for the treatment of suspected tuberculosis. The air-filled pleural space eventually got transformed into calcified pleura with contained effusion.