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The portion of the pleura seen as the outer layer covers the chest wall, the diaphragm and the mediastinum and is often also misleadingly called the parietal pleura. A correct anatomical nomenclature refrains from using the ambiguous terms visceral and parietal in favour of a 4-portion system based on the structures the pleura covers: pulmonary ...
The location of the lesions is mostly in the upper lobes of the lungs, usually in a lymphatic distribution. Thickening of the pleura and interlobular septal is also evident. In addition, pleural/pericardial effusions and mediastinal fat infiltration is appreciated. Definitive diagnosis is achieved through tissue biopsy. [1]
Pleural tumors may be benign (i.e. solitary fibrous tumor) or malignant in nature. Pleural mesothelioma is a type of malignant cancer associated with asbestos exposure. Under most other circumstances, pleural cancers are secondary malignancies associated with lung cancer due to its nearby location or as metastasis such as with breast cancer.
The pleural cavity, or pleural space (or sometimes intrapleural space), is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes , and also to create a pressure gradient .
This involves mechanically irritating the apical and the costal pleura, often with a scratchpad (a small foam pad with coated abrasive) normally used for cleaning electrocautery blade tips. Moreover, surgical removal of parietal pleura is an effective way of achieving stable pleurodesis.
Pleural effusions collect in the costodiaphragmatic recess when in standing position, [2] and present on plain X-rays as "blunting" of the costophrenic angle.. A thoracocentesis (pleural tap) is often performed here while a patient is in full expiration because of less risk of puncturing the lungs and thereby causing pneumothorax.
Solitary fibrous tumor (SFT), also known as fibrous tumor of the pleura, is a rare mesenchymal tumor originating in the pleura [1] or at virtually any site in the soft tissue including the seminal vesicle. [2] Approximately 78% to 88% of SFT's are benign and 12% to 22% are malignant. [3]
In a retrospective review of 204 children with lung tumors, pleuropulmonary blastoma and carcinoid tumor were the most common primary tumors (83% of the 204 children had secondary tumors spread from cancers elsewhere in the body). [1] Pleuropulmonary blastoma is regarded as malignant. The male:female ratio is approximately one.