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Panou V, Bhatnagar R, Rahman N, Christensen TD, Pietersen PI, Arshad A, Laursen CB. Advances in the diagnosis and follow-up of pleural lesions: a scoping review. Expert Rev Respir Med 2024; 18:423-434. [PMID: 38995221 DOI: 10.1080/17476348.2024.2375421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Pleural lesions may have heterogeneous presentation and causes. In recent years, there have been significant advances in pleural lesions diagnostics. The aim of this review is to provide an overview of the state-of-the-art, and recent updates for diagnostic modalities and monitoring regimes for pleural lesions. AREAS COVERED A literature search was conducted through PubMed and Web of Science for relevant articles published from 1 January 2000- 1 March 2023. This article critically appraises the radiological modalities and biopsy techniques that are employed in pleural lesions diagnostics, including chest radiography, thoracic ultrasound, computed tomography, F-fluorodeoxyglycose positron emission tomography, magnetic resonance imaging, percutaneous, and thoracoscopic pleural biopsies with reference to their strengths, limitations, and clinical use. The review asserts also the available literature regarding monitoring algorithms. EXPERT OPINION Despite the recent advances in the field, there are several key areas for improvement, including the development and validation of minimal invasive methods and tools for risk stratification, the integration of multi-omics technologies, the implementation of standardized, evidence-based diagnostic and monitoring guidelines and increased focus on research and patient-centric approaches. The broad establishment of dedicated pleural clinics may significantly assist toward this direction.
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Affiliation(s)
- Vasiliki Panou
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
- Odense Respiratory Research Unit (ODIN) - Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rahul Bhatnagar
- Odense Respiratory Research Unit (ODIN) - Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Respiratory Medicine Department, North Bristol National Health Service Trust, Southmead Hospital, Bristol, UK
- Academic Respiratory Unit, University of Bristol, Bristol, UK
| | - Najib Rahman
- Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Oxford Pleural Unit, Churchill Hospital, Oxford, UK
| | - Thomas Decker Christensen
- Department of Cardiothoracic and Vascular Surgery & Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Pia Iben Pietersen
- Department of Radiology, Odense University Hospital, Odense, Denmark
- UNIFY - Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
| | - Arman Arshad
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Christian B Laursen
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
- Odense Respiratory Research Unit (ODIN) - Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Borgheresi A, Agostini A, Pierpaoli L, Bruno A, Valeri T, Danti G, Bicci E, Gabelloni M, De Muzio F, Brunese MC, Bruno F, Palumbo P, Fusco R, Granata V, Gandolfo N, Miele V, Barile A, Giovagnoni A. Tips and Tricks in Thoracic Radiology for Beginners: A Findings-Based Approach. Tomography 2023; 9:1153-1186. [PMID: 37368547 DOI: 10.3390/tomography9030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/03/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This review has the purpose of illustrating schematically and comprehensively the key concepts for the beginner who approaches chest radiology for the first time. The approach to thoracic imaging may be challenging for the beginner due to the wide spectrum of diseases, their overlap, and the complexity of radiological findings. The first step consists of the proper assessment of the basic imaging findings. This review is divided into three main districts (mediastinum, pleura, focal and diffuse diseases of the lung parenchyma): the main findings will be discussed in a clinical scenario. Radiological tips and tricks, and relative clinical background, will be provided to orient the beginner toward the differential diagnoses of the main thoracic diseases.
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Affiliation(s)
- Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Luca Pierpaoli
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Alessandra Bruno
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Tommaso Valeri
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Ginevra Danti
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Eleonora Bicci
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Michela Gabelloni
- Nuclear Medicine Unit, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Federica De Muzio
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy
| | - Maria Chiara Brunese
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health, Unit 1, 67100 L'Aquila, Italy
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health, Unit 1, 67100 L'Aquila, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Naples, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, 16149 Genoa, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
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Pleural metastasis of pulmonary adenocarcinoma mimicking diffuse mesothelioma: A case report and literature study. Radiol Case Rep 2022; 18:818-823. [PMID: 36582758 PMCID: PMC9793177 DOI: 10.1016/j.radcr.2022.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/05/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
Conditions on pleura cover a broad range of pathology ranging from benign to malignant, which may potentially carry a poor prognosis and lead to high morbidity and mortality. Radiology plays a pivotal role in the diagnosis of pleural malignancy; however, the diagnostic endeavor can be challenging because of overlapping radiological appearances of one condition to another. This case report presents a 61-year-old male with worsening chronic shortness of breath. Despite early imaging resulting in highly suggested mesothelioma, subsequent biopsy proved the malignancy to be pulmonary adenocarcinoma. The patient underwent Pemetrexed-Cisplatin protocol in accordance with the biopsy result, and follow-up imaging depicted a marked improvement of the pleural condition. This case is a prime example of the challenge radiologists have to face regarding pleural tumors and dictates the necessity of a specialized multidisciplinary team to improve the patient's outcome.
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Ajala O, Yoe L, Decatur T, Cole O. Thoracic Splenosis in the Setting of Abdominal Trauma. Cureus 2022; 14:e27851. [PMID: 36110491 PMCID: PMC9462062 DOI: 10.7759/cureus.27851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 12/03/2022] Open
Abstract
The uncommon case of thoracic splenosis is presented in this paper. A patient presents to the hospital with the complaint of dyspnea on exertion. He is incidentally found to have thoracic splenosis. The case of thoracic splenosis is a vital topic to discuss in order to accurately diagnose, recognize, treat symptoms, and explore how it can exacerbate pulmonary or cardiology pathology.
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Steward M, Hall A. A man with a cavitating lung lesion. BMJ 2022; 377:e068810. [PMID: 35613723 DOI: 10.1136/bmj-2021-068810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zhang Z, Yu W, Guan W, Lin Q, Guermazi A. Atypical skeletal involvement in patients with Erdheim-Chester disease: CT imaging findings. Orphanet J Rare Dis 2022; 17:34. [PMID: 35115034 PMCID: PMC8812243 DOI: 10.1186/s13023-022-02185-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives To review retrospectively atypical bone findings from computed tomographic (CT) imaging in patients with Erdheim–Chester disease. Methods All 28 patients with Erdheim–Chester disease (13 men and 15 women; mean age, 45 years; range, 7–63 years) underwent chest-abdomen-pelvis CT. CT images were reviewed and analyzed for the various features of atypical bone lesions by two radiologists in consensus. Results Twenty-one patients had atypical bone involvement. Radiologically, these atypical osseous lesions were categorized into three types: diffuse, nodular and patchy. Eleven (52%) of the 21 patients had spinal lesions, of which four (36%) had the diffuse type, eight (73%) had the nodular pattern, and six (55%) had the patchy pattern. Sixteen (76%) of the 21 patients had pelvic involvement, of which two (13%) were diffuse, nine (56%) were nodular and 11 were (69%) patchy. Ribs were involved in seven (33%) of the 21 patients, with the nodular pattern in one (14%) patient and the patchy type in six (86%) patients. Clavicle involvement was seen in nine (43%) of the 21 patients, of which the diffuse type was found in only one (11%) patient, the nodular type in six (67%) patients, the solitary patchy type in four (44%) patients. Sternum involvement was seen in 10 (48%) of the 21 patients and all were nodular. Conclusions This series provides a detailed description of atypical bone involvement in Erdheim–Chester disease which on CT displays three major patterns. Understanding these patterns may help increase the accuracy of diagnosis of this disease.
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Affiliation(s)
- Zaizhu Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Wei Yu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| | - Wenmin Guan
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.,Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Qiang Lin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.,Department of Radiology, Beijing Arion Cancer Center, Beijing, 100050, China
| | - Ali Guermazi
- Department of Radiology and Medicine, Boston University School of Medicine and Boston Medical Center, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA, 02118, USA
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Kusakabe M, Kazaoka J, Hiyama N, Matsumoto J, Horiuchi H. Pleural nodule with osteal protrusion anterior to the rib tubercle: a case report. Radiol Case Rep 2021; 16:2091-2094. [PMID: 34158900 PMCID: PMC8203593 DOI: 10.1016/j.radcr.2021.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/14/2022] Open
Abstract
Pleural soft tissue density nodules with osteal protrusions are often detected at their characteristic site, the anterior portion of the rib tubercle. Herein, we report a pathologically proven case of this lesion. A 65-year-old man underwent surgery for primary lung cancer in the right middle lobe. Preoperative computed tomography showed a 10-mm pleural soft tissue density nodule with osteal protrusion anterior to the tubercle of the right sixth rib, and this lesion was concomitantly resected. Intraoperative findings showed that this pleural lesion originated from the parietal pleura and was pathologically diagnosed as a benign fibrous tissue. We can avoid unnecessary invasive examinations such as biopsies by recognizing these benign fibrous lesions.
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Affiliation(s)
| | - Junichi Kazaoka
- Department of Radiology, NTT Medical Center Tokyo, Tokyo, Japan.,Department of Radiology, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Noriko Hiyama
- Department of General Thoracic Surgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Jun Matsumoto
- Department of General Thoracic Surgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Hajime Horiuchi
- Department of Pathology, NTT Medical Center Tokyo, Tokyo, Japan
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Tumor and tumorlike conditions of the pleura and juxtapleural region: review of imaging findings. Insights Imaging 2021; 12:97. [PMID: 34236561 PMCID: PMC8266978 DOI: 10.1186/s13244-021-01038-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/11/2021] [Indexed: 01/09/2023] Open
Abstract
Pleural lesions form a diagnostic challenge for the radiologist. Whereas lesions can be initially detected on chest radiographs, CT and MRI imaging are the imaging modalities of choice for further characterization. In a number of cases, imaging findings can be relatively specific. In general unfortunately, imaging findings are rather aspecific. Evolution and extrathoracic imaging findings are important clues toward the diagnosis.
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Bateman M, Kaphle U, Palomino J, Falk N, Kheir F. 54-Year-Old Man With Cough, Chest Pain, and Dyspnea on Exertion. Chest 2021; 158:e299-e303. [PMID: 33280773 DOI: 10.1016/j.chest.2020.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 07/20/2020] [Indexed: 10/22/2022] Open
Abstract
CASE PRESENTATION A 54-year-old man presented with 6 months' history of dry cough and dyspnea on exertion. He also reported intermittent joint pain and orthopnea. He denied fevers, chills, and rashes. His medical history was significant for rheumatoid arthritis, for which he was taking 20 mg of prednisone daily. He had not been receiving adalimumab or methotrexate for several months. He never smoked and drank alcohol occasionally. Family history was significant for rheumatoid arthritis.
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Affiliation(s)
- Marjorie Bateman
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - Upendra Kaphle
- Division of Pulmonary and Critical Care, Kaiser Permanente Roseville and Sacramento Medical Center, Roseville, CA
| | - Jaime Palomino
- Division of Pulmonary, Critical Care and Environmental Medicine, Tulane University School of Medicine, New Orleans, LA; Southeast Louisiana Veterans Healthcare System, New Orleans, LA
| | - Nadja Falk
- Division of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Fayez Kheir
- Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, MA.
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Chatterjee A, Sen Dutt T, Ghosh P, Mukhopadhyay S, Chandra A, Sen S. Inflammatory Lesions Mimicking Chest Malignancy: CT, Bronchoscopy, EBUS, and PET Evaluation From an Oncology Referral Center. Curr Probl Diagn Radiol 2021; 51:235-249. [PMID: 33483189 DOI: 10.1067/j.cpradiol.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022]
Abstract
Infective and inflammatory diseases can mimic malignancy of the lung. Granulomatous inflammations are common causes of pulmonary nodule, mass, or nodal disease. Systemic infection or inflammation also commonly involves the lung that may raise suspicion of a malignant process. Even in patients with a known malignancy, inflammatory diseases can simulate new metastasis or disease progression. Knowledge of the imaging features of these diseases is essential to prevent missed or overdiagnosis of malignancy. Radiologists also need to be familiar with the scope and limitations of bronchoscopy, endobronchial ultrasound, PET-CT, and biopsy to guide clinical management. In this review, we discuss the imaging features and diagnostic approach of common mimickers of chest malignancy that involve the chest wall, pleura, lung parenchyma, and mediastinal nodes.
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Affiliation(s)
- Argha Chatterjee
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India.
| | - Tiyas Sen Dutt
- Department of Pulmonology, Tata Medical Center, Kolkata, West Bengal, India
| | - Priya Ghosh
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Sumit Mukhopadhyay
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Aditi Chandra
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Saugata Sen
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
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Lennartz S, Le Blanc M, Zopfs D, Große Hokamp N, Abdullayev N, Laukamp KR, Haneder S, Borggrefe J, Maintz D, Persigehl T. Dual-Energy CT-derived Iodine Maps: Use in Assessing Pleural Carcinomatosis. Radiology 2019; 290:796-804. [PMID: 30644812 DOI: 10.1148/radiol.2018181567] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate the use of spectral CT for differentiation between noncalcified benign pleural lesions and pleural carcinomatosis. Materials and Methods In this retrospective study, patients who underwent contrast agent-enhanced late venous phase spectral CT of the chest between June 1, 2016, and July 1, 2018 with histopathologic and/or imaging confirmation of noncalcified pleural lesions were evaluated. Conventional images, iodine overlay (IO) images, and virtual monoenergetic images at 40 keV (hereafter, VMI40keV) were reconstructed from contrast-enhanced spectral chest CT. Four blinded radiologists determined lesion presence and indicated lesion conspicuity and diagnostic certainty. Hounsfield unit attenuation from conventional images and iodine concentration (IC) (in milligrams per milliliter) from IO images were determined. Area under the receiver operating characteristics curve determined thresholds for quantitative lesion differentiation and cutoff values were validated in an independent data set. Results Eighty-four patients were included (mean age, 66.2 years; 54 men and 30 women; 44 patients with cancer with confirmed pleural carcinomatosis and 40 patients with benign pleural lesions). The area under the receiver operating characteristics curve for IC was greater than that of conventional Hounsfield units (0.96 vs 0.91; P ≤ .05, respectively). The optimal IC threshold was 1.3 mg/mL, with comparable sensitivity and specificity when applied to the test data set. The sensitivities to depict pleural carcinomatosis with spectral reconstructions versus conventional CT were 96% (199 of 208) and 83% (172 of 208), respectively, with specificities of 84% (161 of 192) and 63% (120 of 192), respectively (P ≤ .001 each). Conclusion Compared with conventional images, spectral CT with iodine maps improved both quantitative and qualitative determination of pleural carcinomatosis versus noncalcified benign pleural lesions. © RSNA, 2019 See also the editorial by K. S. Lee and H. Y. Lee .
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Affiliation(s)
- Simon Lennartz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Markus Le Blanc
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - David Zopfs
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Nils Große Hokamp
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Nuran Abdullayev
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Kai Roman Laukamp
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Stefan Haneder
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Jan Borggrefe
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - David Maintz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Thorsten Persigehl
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
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Reetz JA, Suran JN, Zwingenberger AL, Stefanovski D. Nodules and masses are associated with malignant pleural effusion in dogs and cats but many other intrathoracic CT features are poor predictors of the effusion type. Vet Radiol Ultrasound 2018; 60:289-299. [DOI: 10.1111/vru.12706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/24/2018] [Accepted: 10/27/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jennifer A. Reetz
- Department of Clinical Sciences and Advanced MedicineUniversity of Pennsylvania School of Veterinary Medicine Philadelphia PA 19014
| | - Jantra N. Suran
- Department of Clinical Sciences and Advanced MedicineUniversity of Pennsylvania School of Veterinary Medicine Philadelphia PA 19014
| | - Allison L. Zwingenberger
- Department of Surgical and Radiological SciencesUniversity of California Davis School of Veterinary Medicine Davis CA 95616
| | - Darko Stefanovski
- Department of Clinical Studies New Bolton CenterUniversity of Pennsylvania School of Veterinary Medicine Kennett Square PA 19348
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13
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Fournel L, Bobbio A, Robin E, Canny-Hamelin E, Alifano M, Regnard JF. Clinical presentation and treatment of catameinal pneumothorax and endometriosis-related pneumothorax. Expert Rev Respir Med 2018; 12:1031-1036. [PMID: 30457394 DOI: 10.1080/17476348.2018.1551133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: Catamenial pneumothorax (CP) is defined as a recurrent spontaneous pneumothorax occurring in females of reproductive age. In the 'perimenstrual period,' it is still considered relatively rare although accounting for 20-35% of spontaneous pneumothoraces occurring in premenopausal women. It is the most frequent manifestation of thoracic endometriosis, which can also cause pneumothorax during the intermenstrual period (TER non-CP). Areas covered: In this article, we review and comment the clinical presentation, etiopathogenesis, diagnostic criteria, and therapeutic management of CP and TER non-CP. We particularly emphasize on the surgical optimal treatment and associated multidisciplinary care and follow-up. Electronic databases, mostly PubMed, were used for searching terms including 'catamenial pneumothorax' and 'thoracic endometriosis.' Expert commentary: Clinical presentation and imaging of CP and TER non-CP are often unspecific except for possible visualization of endometriosis foci or diaphragmatic lesions at computed tomography-scan or magnetic resonance imaging. Thus, we recommend careful interrogatory and intraoperative inspection for appropriate diagnosis and treatment of pneumothorax in women. Despite better awareness of surgical teams, CP and TER-non CP are still associated with high rates of postoperative recurrence (around 30%). We strongly advocate for a multidisciplinary management including early surgical and chemical pleurodesis, resection of all visible endometriosis-related lesions, hormonal blockade, and prolonged follow-up.
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Affiliation(s)
- Ludovic Fournel
- a Thoracic surgery department, Paris center hospitals , University Paris Descartes, APHP , Paris , France
| | - Antonio Bobbio
- a Thoracic surgery department, Paris center hospitals , University Paris Descartes, APHP , Paris , France
| | - Edouard Robin
- a Thoracic surgery department, Paris center hospitals , University Paris Descartes, APHP , Paris , France
| | - Emelyne Canny-Hamelin
- a Thoracic surgery department, Paris center hospitals , University Paris Descartes, APHP , Paris , France
| | - Marco Alifano
- a Thoracic surgery department, Paris center hospitals , University Paris Descartes, APHP , Paris , France
| | - Jean-François Regnard
- a Thoracic surgery department, Paris center hospitals , University Paris Descartes, APHP , Paris , France
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14
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Amrith BP, Ray A, Kakkar A, Sinha S. Diffuse pleural thickening: cases of pseudomesotheliomatous adenocarcinoma and pleural tuberculosis. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2018. [DOI: 10.4103/ejb.ejb_121_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Aluja Jaramillo F, Gutierrez F, Bhalla S. Pleural tumours and tumour-like lesions. Clin Radiol 2018; 73:1014-1024. [PMID: 30064697 DOI: 10.1016/j.crad.2018.07.093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/04/2018] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- F Aluja Jaramillo
- Radiology Department, Country Scan, Carrera 16 # 84a-09 Cons. 323, Bogotá, Colombia; Radiology Department, Hospital Universitario San Ignacio, Carrera 7 No 40 - 62, Bogotá, Colombia.
| | - F Gutierrez
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110, USA
| | - S Bhalla
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110, USA
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16
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Santamarina MG, Beddings I, Lermanda Holmgren GV, Opazo Sanchez H, Volpacchio MM. Multidetector CT for Evaluation of the Extrapleural Space. Radiographics 2017; 37:1352-1370. [DOI: 10.1148/rg.2017160180] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mario G. Santamarina
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Ignacio Beddings
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Guillermo V. Lermanda Holmgren
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Hector Opazo Sanchez
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Mariano M. Volpacchio
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
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17
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Mariani F, Gatti B, Rocca A, Bonifazi F, Cavazza A, Fanti S, Tomassetti S, Piciucchi S, Poletti V, Zompatori M. Pleuroparenchymal fibroelastosis: the prevalence of secondary forms in hematopoietic stem cell and lung transplantation recipients. Diagn Interv Radiol 2017; 22:400-6. [PMID: 27460284 DOI: 10.5152/dir.2016.15516] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Pleuroparenchymal fibroelastosis (PPFE) is a rare form of interstitial pneumonia, characterized by elastotic fibrosis involving the pleura and subpleural parenchyma, predominantly in the upper lobes. PPFE can be either idiopathic or secondary and mostly occurs as a late complication of lung or hematopoietic stem cell transplantation (HSCT). The aim of this study was to evaluate the prevalence of secondary forms in transplant recipients. METHODS An expert thoracic radiologist retrospectively reviewed high-resolution computed tomography exams of 700 HSCT recipients and 53 lung transplant recipients from the database of the Radiology Department of S. Orsola-Malpighi Hospital dating back from 2007. For each case that radiologically fulfilled PPFE criteria, the following details were retrieved: clinical characteristics, laboratory and functional data, pathologic findings (obtained from one patient) and metabolic data (obtained from three patients). RESULTS Six cases clinically and radiologically consistent with PPFE were identified: two HSCT recipients (0.28%) and four lung transplant recipients (7.54%). CONCLUSION In this study, PPFE was strongly associated with lung transplants as a late complication, with a prevalence of 7.54%.
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Affiliation(s)
- Francesca Mariani
- Department of Radiology, S. Orsola-Malpighi Hospital, Bologna, Italy.
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18
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Valente T, Tortora G, Bocchini G, Rea G, Marino M, Muto M. MDCT and US of intrathoracic extrapleural space soft tissue-containing lesions: US extrapleural fat sign and MDCT fat ghost ribs sign. Radiol Med 2017; 122:479-486. [DOI: 10.1007/s11547-017-0744-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 02/22/2017] [Indexed: 11/29/2022]
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19
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Abstract
Erdheim-Chester disease (ECD) is a rare multisystemic non-Langerhans cell histiocytosis that may be clonal and inflammatory in origin. The hallmark of the disease is infiltration of various organ systems by CD68+/CD1a- histiocytes containing foamy lipid-laden inclusions. The manifestations and course of the disease are variable and depend on the organ systems that are affected. Patients may be asymptomatic or may develop life-threatening complications, including myocardial infarction. The most common clinical manifestation is lower extremity bone pain. Imaging manifestations of the disease include symmetric osteosclerosis of the distal long bones, circumferentially “coated” aorta, pleural and pericardial thickening/fluid, and perirenal encasement. Treatment for the disease is evolving, particularly with the use of molecular BRAF inhibition. We present a case of a patient with ECD initially suspected based on the imaging manifestations.
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Affiliation(s)
- Atman A Dave
- Medical Education, Saint Luke's Hospital of Kansas City
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20
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Vargas D, Richards JC, Ocazionez D, Sirajuddin A, Browne L, Restrepo CS. Cardiothoracic manifestations of primary histiocytoses. Br J Radiol 2016; 89:20160347. [PMID: 27603510 DOI: 10.1259/bjr.20160347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The objectives of this article were: (1) to review common and rare manifestations of systemic and pulmonary Langerhans cell histiocytosis, Rosai-Dorfman disease, Erdheim-Chester disease and juvenile xanthogranuloma; (2) to provide the reader with important pathologic, epidemiologic and clinical features of these diseases. The histiocytoses are a diverse group of diseases which typically manifest with multiorgan involvement. Understanding the pathologic, epidemiologic and clinical features of these entities can help the radiologist suggest an accurate diagnosis of histiocytosis when typical imaging features are encountered.
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Affiliation(s)
- Daniel Vargas
- 1 Department of Radiology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - J Caleb Richards
- 6 Department of Radiology, National Jewish Health. Denver, CO, USA
| | - Daniel Ocazionez
- 2 Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Arlene Sirajuddin
- 3 Department of Medical Imaging, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Lorna Browne
- 4 Department of Radiology, Children's Hospital of Colorado, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Carlos S Restrepo
- 5 Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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21
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Desbuquoit D, Van Hecke S, Even P, Parizel PM, van Meerbeeck JP, Snoeckx A. Pleural Nodules and Mediastinal Lymphadenopathy in a Smoker: An Unusual Case Report. Case Rep Oncol 2016; 9:488-492. [PMID: 27721773 PMCID: PMC5043224 DOI: 10.1159/000448803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 07/29/2016] [Indexed: 11/30/2022] Open
Abstract
The authors report a case of thoracic splenosis, which is the autotransplantation of splenic tissue into the pleural cavity. Splenosis in the chest is a rare entity and most often an incidental finding on chest computed tomography, typically showing solitary or multiple well-defined, noncalcified pleural nodules of variable size in the left hemithorax. It is important to include this benign pathology in the differential diagnosis among other, generally malignant, pleural lesions. Imaging clues to the diagnosis are absence of the spleen and/or associated rib fractures. Early identification of thoracic splenosis as a cause of pleural nodules can prevent unnecessary and risky invasive procedures, such as biopsy or surgery.
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Affiliation(s)
- Damien Desbuquoit
- Department of Radiology, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Stijn Van Hecke
- Department of Nuclear Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Pjotr Even
- Department of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Paul M Parizel
- Department of Radiology, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Jan P van Meerbeeck
- Department of Thoracic Oncology, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Annemie Snoeckx
- Department of Radiology, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
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22
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Computed tomography identification of an exophytic colonic liposarcoma. Radiol Case Rep 2016; 11:161-4. [PMID: 27594941 PMCID: PMC4996942 DOI: 10.1016/j.radcr.2016.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/07/2016] [Accepted: 06/15/2016] [Indexed: 11/20/2022] Open
Abstract
It may be difficult to ascertain the relationship between a large intra-abdominal tumor and the adjacent organs if they are close together. In the current case, a definitive preoperative diagnosis of an exophytic colonic tumor was obtained by the demonstration of obtuse angles between the tumor and colon and by distinct recognition of the mucosa-submucosa of the colonic wall on computed tomography; the accuracy of this preoperative diagnosis was subsequently confirmed by pathologic findings.
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23
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Ahuja J, Kanne JP, Meyer CA, Pipavath SNJ, Schmidt RA, Swanson JO, Godwin JD. Histiocytic disorders of the chest: imaging findings. Radiographics 2016; 35:357-70. [PMID: 25763722 DOI: 10.1148/rg.352140197] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Histiocytic disorders of the chest comprise a broad spectrum of diseases. The lungs may be involved in isolation or as part of systemic disease. Some of these disorders are primary and have unknown etiology, and others result from a histiocytic response to a known cause. Among primary histiocytic disorders, pulmonary Langerhans cell histiocytosis (PLCH) is the most common; others include Erdheim-Chester disease and Rosai-Dorfman disease. Adult PLCH occurs almost exclusively in adults aged 20-40 years who smoke. Pediatric PLCH is extremely rare and typically occurs as part of multisystemic disease. Erdheim-Chester disease affects middle-aged and older adults; thoracic involvement usually occurs as part of systemic disease. Rosai-Dorfman disease affects children and young adults and manifests as painless cervical lymphadenopathy. Examples of secondary histiocytic disorders are storage diseases such as Gaucher disease, Niemann-Pick disease, and Fabry disease; pneumoconiosis such as silicosis and coal workers' pneumoconiosis; and infections such as Whipple disease and malakoplakia. These disorders are characterized at histopathologic examination on the basis of infiltration of alveoli or the pulmonary interstitium by histiocytes, which are a group of cells that includes macrophages and dendritic cells. Dendritic cells are a heterogeneous group of nonphagocytic antigen-presenting immune cells. Immunohistochemical markers help to distinguish among various primary histiocytic disorders. Characteristic radiologic findings in the appropriate clinical context may obviate biopsy to establish a correct diagnosis. However, in the absence of these findings, integration of clinical, pathologic, and radiologic features is required to establish a diagnosis.
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Affiliation(s)
- Jitesh Ahuja
- From the Departments of Radiology (J.A., S.N.J.P., J.O.S., J.D.G.) and Pathology (R.A.S.), University of Washington, 1959 NE Pacific St, UW Mailbox 357115, Seattle, WA 98195; and Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, Wis (J.P.K., C.A.M.)
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24
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Maxim LD, Niebo R, Utell MJ. Are pleural plaques an appropriate endpoint for risk analyses? Inhal Toxicol 2015; 27:321-34. [DOI: 10.3109/08958378.2015.1051640] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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25
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de Paula MCF, Escuissato DL, Belém LC, Zanetti G, Souza AS, Hochhegger B, Nobre LF, Marchiori E. Focal pleural tumorlike conditions: nodules and masses beyond mesotheliomas and metastasis. Respir Med 2015; 109:1235-43. [PMID: 26094051 DOI: 10.1016/j.rmed.2015.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 05/07/2015] [Accepted: 06/08/2015] [Indexed: 12/11/2022]
Abstract
A tumorlike condition of the pleura is any nonmalignant lesion of the pleura or within the pleural space that could be confused with a pleural tumor on initial imaging. Tumorlike conditions of the pleura are relatively rare compared with neoplastic lesions such as mesotheliomas and metastases. Imaging-based diagnosis of these conditions can be difficult due to the similarity of appearance. Thus, recognition of certain imaging patterns and interpretation of these patterns in the clinical context are important. Pleural endometriosis, thoracic splenosis, thoracolithiasis, foreign bodies, pleural pseudotumors and pleural plaques are significant examples of focal tumorlike conditions discussed in this article. Computed tomography is the mainstay imaging technique for the primary assessment of pleural disease, but other imaging methods, such as magnetic resonance imaging and positron-emission tomography, can be of great support in the diagnosis.
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Affiliation(s)
| | | | | | - Gláucia Zanetti
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - Bruno Hochhegger
- Santa Casa de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | | | - Edson Marchiori
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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26
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Visouli AN, Zarogoulidis K, Kougioumtzi I, Huang H, Li Q, Dryllis G, Kioumis I, Pitsiou G, Machairiotis N, Katsikogiannis N, Papaiwannou A, Lampaki S, Zaric B, Branislav P, Porpodis K, Zarogoulidis P. Catamenial pneumothorax. J Thorac Dis 2014; 6:S448-60. [PMID: 25337402 DOI: 10.3978/j.issn.2072-1439.2014.08.49] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 08/26/2014] [Indexed: 01/30/2023]
Abstract
Catamenial pneumothorax (CP) is the most common form of thoracic endometriosis syndrome, which also includes catamenial hemothorax, catamenial hemoptysis, catamenial hemopneumothorax and endometriosis lung nodules, as well as some exceptional presentations. Usually onset of lung collapse is less than 72 hours after menstruation. Most commonly occurs in women aged 30-40 years, but has been diagnosed in young girls as early as 10 years of age and post menopausal women (exclusively in women of menstrual age) most with a history of pelvic endometriosis. Diagnosis can be hinted by high recurrence rates of lung collapse in a woman of reproductive age with endometriosis. Moreover; CA-125 is elevated. Video-assisted thoracoscopy or medical thoracoscopy is used for confirmation. In our current work we will present all aspects of CP from diagnosis to treatment.
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Affiliation(s)
- Aikaterini N Visouli
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Konstantinos Zarogoulidis
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Ioanna Kougioumtzi
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Haidong Huang
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Qiang Li
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Georgios Dryllis
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Ioannis Kioumis
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Georgia Pitsiou
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Nikolaos Machairiotis
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Nikolaos Katsikogiannis
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Antonis Papaiwannou
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Sofia Lampaki
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Bojan Zaric
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Perin Branislav
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Konstantinos Porpodis
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
| | - Paul Zarogoulidis
- 1 Interbalkan Medical Center, Pylea, Thessaloniki, Greece ; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200433, China ; 5 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 6 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 7 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
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27
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Abstract
Tumors of the pleura are not uncommon and diagnosis is clinched by combined imaging and clinical correlation. Malignant tumors are more common than benign tumors. Initial imaging modalities are chest radiography and Computed Tomography (CT). Further characterization may be required using Ultrasoundgraphy (USG), Magnetic resonance Imaging (MRI) and PET-CT. Biopsy remains gold standard. This article highlights various common and uncommon tumors of pleura and characteristic imaging findings.
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Affiliation(s)
- Binit Sureka
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Brij Bhushan Thukral
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Mahesh Kumar Mittal
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Aliza Mittal
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Mukul Sinha
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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28
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Marchiori E, Rodrigues RS, Reis MCM, Zanetti G, Menna Barreto M. Pleural nodules in a patient with a colonic tumour. Thorax 2013; 69:395, 398. [PMID: 24368715 DOI: 10.1136/thoraxjnl-2013-204727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Edson Marchiori
- Department of Radiology, Federal University of Rio de Janeiro, , Rio de Janeiro, Brazil
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29
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Abstract
Catamenial pneumothorax is a rare complication secondary to pleural endometriosis. We present a case of a 37-year-old-female with a history of recurrent pneumothoraces with an associated temporal relationship to the onset of her menses. In addition to her recurrent pneumothoraces, on further evaluation, she was found to have multiple nodular masses within the omentum. A thoracoscopic biopsy was subsequently performed, which showed endometrial implants within the pleural space and within the omental cavity. The radiological features and pathogenesis of this rare disease are reviewed and discussed with reference to relevant literature.
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Affiliation(s)
- Pardeep Athwal
- Department of Radiology, University of Connecticut John Dempsey Hospital, Farmington, CT, USA
| | - Krishna Patel
- Department of Radiology, University of Connecticut John Dempsey Hospital, Farmington, CT, USA
| | - Cameron Hassani
- Department of Radiology, University Hospital of Brooklyn at Long Island College Hospital, Brooklyn NY, USA
| | - Shapour Bahadori
- Department of Radiology, University of Connecticut John Dempsey Hospital, Farmington, CT, USA
| | - Peter Nardi
- Department of Radiology, University Hospital of Brooklyn at Long Island College Hospital, Brooklyn NY, USA
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30
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Abstract
Primary pleural tumors other than mesothelioma account for fewer than 1% of all lung cancers, and consequently they pose diagnostic and management challenges. Their treatment must be targeted toward the specific tumor type and is often quite different from the treatment for mesothelioma or metastases. Despite the best efforts at diagnosing and treating these tumors, the prognosis associated with some of the benign and many of the malignant variants of these tumors remains poor. In this review, we describe the radiologic and pathologic features of the less common primary pleural tumors and propose a diagnostic approach to their evaluation.
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Affiliation(s)
- Christopher T Erb
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, 300 Cedar Street, TAC S-441, New Haven, CT 06520, USA
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