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Chest Aug 2018
Topics: Pleura; Ultrasonography
PubMed: 30080507
DOI: 10.1016/j.chest.2018.04.002 -
The Annals of Thoracic Surgery Aug 2021Melanomas represent 3% of all skin cancers but 65% of skin cancer deaths. Metastatic melanoma constitutes about 5% of all secondary malignancies of the lung, yet only 2%...
Melanomas represent 3% of all skin cancers but 65% of skin cancer deaths. Metastatic melanoma constitutes about 5% of all secondary malignancies of the lung, yet only 2% of patients with thoracic metastases have pleural effusions. We report the case of an 80-year-old patient with right-sided pleural effusion and a history of cutaneous melanoma over the left leg. Thoracoscopy revealed numerous clusters of pink and black masses arising from the visceral and parietal pleura along with the diaphragmatic surface. Biopsies confirmed the diagnosis of metastatic cutaneous melanoma.
Topics: Aged, 80 and over; Biopsy; Humans; Male; Melanoma; Pleura; Pleural Neoplasms; Skin Neoplasms; Thoracoscopy; Tomography, X-Ray Computed; Melanoma, Cutaneous Malignant
PubMed: 33421399
DOI: 10.1016/j.athoracsur.2020.09.088 -
Respirology (Carlton, Vic.) Feb 2018Unexpandable lung is a common complication of malignant pleural effusions and inflammatory pleural diseases, such as pleural infection (e.g. empyema and complicated... (Review)
Review
Unexpandable lung is a common complication of malignant pleural effusions and inflammatory pleural diseases, such as pleural infection (e.g. empyema and complicated parapneumonic effusion) and noninfectious fibrinous pleuritis. Unexpandable lung due to pleural disease may be because of an active pleural process, and is referred to as malignant or inflammatory lung entrapment. An unexpandable lung may also be encountered in the setting of remote pleural inflammation resulting in a mature fibrous membrane overlying the visceral pleura preventing full expansion of the lung. This condition is termed trapped lung and may be understood as a form of defective healing of the pleural space. Trapped lung typically presents as a chronic, stable pleural effusion without evidence of active pleural disease. An unexpandable lung most often manifests itself as an inability of fully expanding the lung with pleural space drainage. Patients will either develop chest pain preventing complete drainage of the pleural space or develop a post-procedure pneumothorax. Pleural manometry and radiological imaging are useful in the assessment of an unexpandable lung. Pleural manometry can demonstrate abnormal lung expansion during drainage and imaging will demonstrate abnormal visceral pleural thickening found in trapped lung or malignant and inflammatory lung entrapment.
Topics: Chest Tubes; Drainage; Humans; Lung Diseases; Pleura; Pleural Effusion; Pleural Effusion, Malignant; Pleurisy; Pneumothorax
PubMed: 29064169
DOI: 10.1111/resp.13199 -
Ultraschall in Der Medizin (Stuttgart,... Apr 2024The CME review presented here is intended to explain the significance of pleural sonography to the interested reader and to provide information on its application. At...
The CME review presented here is intended to explain the significance of pleural sonography to the interested reader and to provide information on its application. At the beginning of sonography in the 80 s of the 20th centuries, with the possible resolution of the devices at that time, the pleura could only be perceived as a white line. Due to the high impedance differences, the pleura can be delineated particularly well. With the increasing high-resolution devices of more than 10 MHz, even a normal pleura with a thickness of 0.2 mm can be assessed. This article explains the special features of the examination technique with knowledge of the pre-test probability and describes the indications for pleural sonography. Pleural sonography has a high value in emergency and intensive care medicine, preclinical, outpatient and inpatient, in the general practitioner as well as in the specialist practice of pneumologists. The special features in childhood (pediatrics) as well as in geriatrics are presented. The recognition of a pneumothorax even in difficult situations as well as the assessment of pleural effusion are explained. With the high-resolution technology, both the pleura itself and small subpleural consolidations can be assessed and used diagnostically. Both the direct and indirect sonographic signs and accompanying symptoms are described, and the concrete clinical significance of sonography is presented. The significance and criteria of conventional brightness-encoded B-scan, colour Doppler sonography (CDS) with or without spectral analysis of the Doppler signal (SDS) and contrast medium ultrasound (CEUS) are outlined. Elastography and ultrasound-guided interventions are also mentioned. A related further paper deals with the diseases of the lung parenchyma and another paper with the diseases of the thoracic wall, diaphragm and mediastinum.
Topics: Humans; Child; Pleura; Pleural Effusion; Lung; Lung Diseases; Thorax; Ultrasonography
PubMed: 38237634
DOI: 10.1055/a-2189-5050 -
Seminars in Ultrasound, CT, and MR Feb 2024Thoracic Ultrasonography involves the ultrasonographic examination of the lungs, pleura, and diaphragm. This provides a plethora of clinical information during the point... (Review)
Review
Thoracic Ultrasonography involves the ultrasonographic examination of the lungs, pleura, and diaphragm. This provides a plethora of clinical information during the point of care assessment of patients. The air filled lungs create consistent artifacts and careful examination and understanding of these artefactual signs can provide useful information on underlying clinicopathologic states. This review aims to provide a review of the ultrasound signs and features that can be seen in horacic ultrasonography and summarize the clinical evidence to support its use.
Topics: Humans; Pleura; Diaphragm; Point-of-Care Systems; Lung; Ultrasonography
PubMed: 38244897
DOI: 10.1053/j.sult.2024.01.001 -
Neurosurgery Clinics of North America Jan 2020The lateral retropleural thoracic approach offers minimally invasive access for the treatment of thoracic spine pathology, specifically thoracic herniated discs.... (Review)
Review
The lateral retropleural thoracic approach offers minimally invasive access for the treatment of thoracic spine pathology, specifically thoracic herniated discs. Alternatives to the retropleural approach traditionally included posterolateral or anterior approaches, which carry increased morbidity. The retropleural approach affords lateral access to the thoracic spine that allows for addressing pathology such as herniated discs, corpectomy, tumor, or trauma. This article outlines preoperative workup and planning, intraoperative steps, tips, and postoperative care.
Topics: Humans; Minimally Invasive Surgical Procedures; Neurosurgical Procedures; Pleura; Spine; Thoracic Surgical Procedures; Thoracic Vertebrae; Treatment Outcome
PubMed: 31739928
DOI: 10.1016/j.nec.2019.08.005 -
Clinical Radiology Dec 2018There are various neoplasms and tumour-like conditions of the pleura. Mesothelioma is perhaps the most widely recognised; however, there are many others that are more... (Review)
Review
There are various neoplasms and tumour-like conditions of the pleura. Mesothelioma is perhaps the most widely recognised; however, there are many others that are more common and should be considered. Understanding the similarities and differences can be helpful in managing the patient with a newly found pleural lesion. We will discuss clinical symptoms at presentation and describe the imaging findings associated with these tumours, starting with conventional radiology, and correlating with computed tomography and combined positron-emission tomography (PET)/computed tomography (CT). Finally, imaging characteristics that help differentiation between the benign and malignant varieties will be reviewed.
Topics: Diagnosis, Differential; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Neoplasm Staging; Pleura; Pleural Neoplasms; Positron-Emission Tomography; Radiopharmaceuticals; Tomography, X-Ray Computed
PubMed: 30064697
DOI: 10.1016/j.crad.2018.07.093 -
Clinical Imaging Nov 2021Extrapleural space (EPS) is a potential space between the outer layer of the parietal pleura and the inner layer of the chest wall and the diaphragm. Many different... (Review)
Review
Extrapleural space (EPS) is a potential space between the outer layer of the parietal pleura and the inner layer of the chest wall and the diaphragm. Many different pathologies including chronic inflammatory conditions, infections, trauma, neoplastic disease (both benign and malignant) as well as many infiltrative disorders can involve the EPS. It is one of the frequently overlooked entity on imaging due to relative lack of understanding of the anatomy and the imaging appearances of the diseases localized to this space. The knowledge of the EPS is essential for the radiologists as the pathologies which involve the EPS may require different treatment approach compared to pleural or parenchymal lung disease. Additionally, the EPS involvement may influence the staging and treatment planning for chest malignancies. In this review, we give an overview of the anatomy and various pathologies involving EPS, utility of different imaging modalities in the evaluation of EPS lesions with emphasis on cross sectional imaging and emerging technologies like spectral CT and its role in recognizing the imaging features which enable specific diagnosis of various pathologies.
Topics: Diaphragm; Humans; Multimodal Imaging; Pleura; Pleural Neoplasms; Thoracic Neoplasms; Tomography, X-Ray Computed
PubMed: 33892397
DOI: 10.1016/j.clinimag.2021.03.038 -
RoFo : Fortschritte Auf Dem Gebiete Der... Apr 2021
Topics: Adult; Female; Humans; Lung; Paresthesia; Pleura; Solitary Fibrous Tumors; Thorax; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 33302313
DOI: 10.1055/a-1224-4279 -
Seminars in Respiratory and Critical... Dec 2014Ultrasonography of the thorax has become a more recognized tool in pulmonary medicine, thanks to continuing clinical research that has proven its many valuable roles in... (Review)
Review
Ultrasonography of the thorax has become a more recognized tool in pulmonary medicine, thanks to continuing clinical research that has proven its many valuable roles in the day-to-day management of pulmonary and pleural diseases. Ultrasound examination is a cost-effective imaging modality that permits the pulmonologist to obtain information about the pathologies in the thorax without the risk of exposure to ionizing radiation, providing the examiner with real-time and immediate results. Its ease of use and training along with its portability to the patient's bedside and accurate examination of the pleural space has allowed for safer pleural procedures such as thoracentesis, chest tube placement, tunneled pleural catheter placement, and medical thoracoscopy. In this review, we summarize the technique of chest ultrasonography, compare ultrasound to other frequently used thoracic imaging modalities, and focus on its use in obtaining pleural access while performing invasive pleural procedures.
Topics: Chest Tubes; Diagnosis, Differential; Humans; Pleura; Pleural Diseases; Pleural Effusion; Pneumothorax; Pulmonary Disease, Chronic Obstructive; Thorax; Ultrasonography, Interventional
PubMed: 25463160
DOI: 10.1055/s-0034-1395794