Pleural thickening and adhesions

Introduction In patients with tuberculosis, pleurisy, and chest injury, there is often oozing fluid in the pleural cavity. Once the fibrin in the effusion is deposited on the pleura, the pleura can be thickened. If fibrin is succulent, the opposite pleura It gradually sticks, or there is granulation tissue proliferation in the pleural cavity, which can also lead to thickening of the pleura and adhesion. A large amount of pleural thickening and adhesion can cause the rib space to shrink, the mediastinum shifts to the affected side, the spine is convex toward the opposite side, and the diaphragm rises. A wide range of lesions can cause the hilar to be lifted and the trachea displaced to the affected side.

Cause

The cause of pleural thickening adhesion:

1. The blood in the chest (blood chest) is usually caused by chest damage.

2. The empyema in the thoracic cavity (purulent chest) can be caused by the spread of pneumonia or lung abscess to the chest cavity.

3. Intraluminal chyle accumulation (chylomicron) is caused by damage to the main lymphatic vessels (thoracic ducts) in the thoracic cavity or obstruction of the tumor.

4. The lungs of trematode disease mainly showed infiltration, cyst nodules and induration, but pleural adhesions were also found. Pneumonia pseudotumor chest X-ray and CT scan, a few may also have pleural adhesions.

5. In the late stage of silicosis, due to the contraction and adhesion of the fibrous tissue of the lungs, the transverse sputum can present a "sky-like" image, showing pleural adhesions at the base of the lung.

6. The accumulation of high cholesterol in the thoracic cavity occurs in some chronic pleural effusions, such as tuberculosis (more common, no longer described) or rheumatoid arthritis (more than half of the autopsy has adhesive pleurisy, common in severely advanced patients) To the cause.

an examination

Related inspection

Thoracic chest CT examination

Localized pleural thickening and adhesions are common at the rib angles, making the rib angles dull, lighter, or flattened. Under the fluoroscopy, it can be seen that the transverse movement is weakened.

The pleura can also have a wide range of layer thickening and adhesion. If the thickness is not large, and it is located in the front chest wall or the back chest wall, it can not cause obvious X-ray changes. When the pleural thickening reaches a certain thickness, the affected side is made. The lung field density increases, and when turned to the tangent position, there is a sharp sharp shadow on the inner edge of the thorax and the lung field.

Differential diagnosis

Differential diagnosis of pleural thickening adhesion:

Pleural thickening and adhesion, there are limitations and extensive points, need to identify each other. Adhesion of a wide range of visceral layers can affect the respiratory function of the lungs. Extensive adhesion of the wall layer can result in narrowing of the intercostal space and shrinking of the thorax. Limitations often occur at the corners of the ribs, causing the squat movement to weaken there. The pleura can also have a wide range of layer-like augmentation and adhesion, which not only causes the rib gap to shrink, the mediastinum shifts to the affected side, the spine is convex to the opposite side, the transverse sac is raised, and the hilar is lifted, and the trachea is lifted. The affected side is displaced, and the pleural adhesion is in addition to the membranous shape. There is also a cord-like type, which mainly occurs between the chest wall and a lung surface. This adhesion is caused by the upper lesion of the lungs. Treatment of localized pleural thickening and adhesion, common at the rib angle, makes the rib angle obscure, shallow or flattened. Under the fluoroscopy, it can be seen that the transverse movement is weakened.

The pleura can also have a wide range of layer thickening and adhesion. If the thickness is not large, and it is located in the front chest wall or the back chest wall, it can not cause obvious X-ray changes. When the pleural thickening reaches a certain thickness, the affected side is made. The lung field density increases, and when turned to the tangent position, there is a sharp sharp shadow on the inner edge of the thorax and the lung field. A large amount of pleural thickening and adhesion can cause the rib space to shrink, the mediastinum shifts to the affected side, the spine is convex toward the opposite side, and the diaphragm rises. A wide range of lesions can cause the hilar to be lifted and the trachea displaced to the affected side.

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