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The pulmonary pleura covers the entire lung parenchyma. It meets the mediastinal pleura at the root of the lung ("hilum") through a smooth fold known as pleural reflection. A bell sleeve-like extension of the pulmonary pleura hanging under to the hilum is known as the pulmonary ligament.
Each lung is enclosed within a pleural sac of two pleurae which allows the inner and outer walls to slide over each other whilst breathing takes place, without much friction. The inner visceral pleura divides each lung as fissures into sections called lobes. The right lung has three lobes and the left has two.
Lung parenchyma showing damage due to large subpleural bullae. Parenchyma (/ p ə ˈ r ɛ ŋ k ɪ m ə /) [1] [2] is the bulk of functional substance in an animal organ or structure such as a tumour. In zoology, it is the tissue that fills the interior of flatworms. In botany, it is some layers in the cross-section of the leaf. [3]
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 .
Typically, an area of white lung is seen on a standard X-ray. [5] Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in radiography and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections.
Bullae can become extensive and combine to form giant bullae. These can be large enough to take up a third of a hemithorax, compress the lung parenchyma, and cause displacement. The emphysema is now termed giant bullous emphysema, more commonly called vanishing lung syndrome due to the compressed parenchyma. [28]
The thickness ranges from less than 1 mm up to 1 cm or more and may extend for a few millimeters into the lung parenchyma. [5] Fibrous strands ("crow's feet") extending from the thickened pleura into the lung parenchyma can be often detected on CT scan. Diffuse pleural thickening develops 20 to 40 years after first exposure. [11]
The endometrial tissue settles in the lung parenchyma or pleura. [8] A review of autopsy data showed that patients with endometriosis have bilateral pulmonary lesions, which supports the vascular embolisation theory. The pleural and/or diaphragmatic lesions were always found on the left side, which supports the theory of coelomic metaplasia.