Parietal Pleura

2020 ◽  
Author(s):  
Keyword(s):  
Parietal Pleura

scholarly journals Validation of the T Descriptor (TNM-8) in T3N0 Non-Small-Cell Lung Cancer Patients; a Bicentric Cohort Analysis with Arguments for Redefinition

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1812
Author(s):  
Philip Baum ◽  
Samantha Taber ◽  
Stella Erdmann ◽  
Thomas Muley ◽  
Mark Kriegsmann ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Cohort Analysis ◽  
Lung Cancer Surgery ◽  
Tnm Staging ◽  
Parietal Pleura ◽  
Tumor Diameter ◽  
Lung Cancer Patients ◽  
Multiple Nodules

The current pT3N0 category represents a heterogeneous subgroup involving tumor size, separate tumor nodes in one lobe, and locoregional growth pattern. We aim to validate outcomes according to the eighth edition of the TNM staging classification. A total of 281 patients who had undergone curative lung cancer surgery staged with TNM-7 in two German centers were retrospectively analyzed. The subtypes tumor size >7 cm and multiple nodules were grouped as T3a, and the subtypes parietal pleura invasion and mixed were grouped as T3b. We stratified survival by subtype and investigated the relative benefit of adjuvant chemotherapy according to subtype. The 5-year overall survival (OS) rates differed between the different subtypes tumor diameter >7 cm (71.5%), multiple nodules in one lobe (71.0%) (grouped as T3a), parietal pleura invasion (59.%), and mixed subtype (5-year OS 50.3%) (grouped as T3b), respectively. The cohort as a whole did not gain significant OS benefit from adjuvant chemotherapy. In contrast, adjuvant chemotherapy significantly improved OS in the T3b subgroup (logrank p = 0.03). This multicenter cohort analysis of pT3N0 patients identifies a new prognostic mixed subtype. Tumors >7 cm should not be moved to pT4. Patients with T3b tumors have significantly worse survival than patients with T3a tumors.

scholarly journals Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Dong ◽  
Chun-Li Wu ◽  
Yin-liang Sheng ◽  
Bin Wu ◽  
Guan-Chao Ye ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Lesion ◽  
Parietal Pleura ◽  
Catamenial Pneumothorax ◽  
Endometrial Cells ◽  
Retrograde Menstruation ◽  
History Of ◽  
The Right ◽  
Thoracic Endometriosis

Abstract Background Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis. Case presentation A 43-year-old woman with a history of endometriosis came to our hospital due to recurring pneumothorax during menstruation. Uniportal Video-assisted Thoracoscopic Surgery (VATS) exploration was performed on the eve of menstruating. We thoroughly explored the diaphragm, visceral and parietal pleura: The lung surface was scattered with yellowish-brown implants; no bullae were found; multiple diaphragmatic defects were found on the dome. And surprisingly, we caught a fascinating phenomenon: Bubbles were slipping into pleural cavity through diaphragmatic defects. We excised the diaphragmatic lesions and wedge resected the right upper lung lesion; cleared the deposits and flushed the thoracic cavity with pure iodophor. Diaphragmatic lesions confirmed the presence of endometriosis, and interestingly enough, microscopically, endometrial cells were shedding with impending menses. After a series of intraoperative operations and postoperative endocrine therapy, the disease did not recur after a period of follow-up. Conclusion We have witnessed the typical signs of catamenial pneumothorax at the accurate timing: Not only observed the process of gas migration macroscopically, but also obtained pathological evidence of diaphragmatic periodic perforation microscopically, which is especially precious and confirms the existing theory that retrograde menstruation leads to diaphragmatic endometriosis, and the diaphragmatic fenestration is obtained due to the periodic activities of ectopic endometrium.

Alveolar liquid pressure measured in the intact rabbit chest by micropuncture

1993 ◽  
Vol 75 (4) ◽  
pp. 1525-1528 ◽  
Author(s):  
S. Ganesan ◽  
S. J. Lai-Fook
Keyword(s):  
Ambient Pressure ◽  
Lateral Position ◽  
Measuring System ◽  
Parietal Pleura ◽  
Liquid Pressure ◽  
Left Lateral Position ◽  
Isolated Lung ◽  
Residual Capacity ◽  
Alveolar Liquid

Previous measurements in isolated lung showed that alveolar liquid pressure was near the pleural pressure at a lung volume near functional residual capacity (FRC). In this study we verified that alveolar liquid pressure in vivo was similar to that of the isolated lung. In anesthetized paralyzed rabbits (3#x2013;4 kg, n = 9) ventilated with 100% O2 in the left lateral position, we made a pleural window between the fifth and sixth ribs near midchest by removing tissue down to the parietal pleura. Window height was 6 cm above the base of the lung. During apnea, alveolar liquid and pleural pressures were measured by puncturing through the pleural window with micropipettes connected to a servo-nulling pressure-measuring system. Pressures were measured at airway pressures of 0 (FRC) and 10 cmH2O both in vivo and postmortem. In vivo, alveolar liquid and pleural pressures relative to ambient pressure averaged -2.3 +/- 1.4 (SD) and -1.8 +/- 0.9 cmH2O at FRC and increased to 3.3 +/- 1.8 and 1.8 +/- 1.6 cmH2O after inflation to an airway pressure of 10 cmH2O, respectively. Similar values were obtained postmortem. These results were similar to previous measurements in the isolated lung.

scholarly journals Pleural Empyema Menagement: A Brief Review of Litterature

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Milos Arsenijevic ◽  
Slobodan Milisavljevic ◽  
Stanko Mrvic ◽  
Dragan Stojkovic
Keyword(s):  
Surgical Procedures ◽  
General Condition ◽  
Dynamic Process ◽  
Clinical Laboratory ◽  
Pleural Empyema ◽  
Pleural Space ◽  
Parietal Pleura ◽  
Disease Development ◽  
Thoracic Empyema ◽  
Acute Empyema

AbstractPleural empyema, defined as the presence of purulent material within the pleural space, is the consequence of a suppurative process involving the serous pleural layers. Thoracic empyema is a dynamic process, inflammatory in origin and taking place within a preformed space bordered by both the visceral and parietal pleura. It is a complex clinical entity, neither a sole clinical, laboratory, nor a radiological diagnosis. The primary therapeutic aim: ‘ubi pus evacua’ — if you find pus remove it—has not changed since the age of Celsus. Therefore, treatment of the acute empyema of the pleura is directed to early and complete evacuation of empirical fluid and content, achieving full re-expansion of the lungs and eradication of the infection using appropriate surgical procedures, antibiotics and other supportive procedures. The optimum method of treating empyema should be adjusted to the condition of the patient and the stage of the disease in which the patient is located. The method of treatment depends on the etiology (pneumonic or traumatic), the general condition of the patient and the stage of disease development. By reviewing the available literature, it can be concluded that treating the pleural empyemas is a demanding procedure, in which it is necessary for the treating physician to apply all of his knowledge, and that there is good cooperation with the patient.

Parietal Pleura and Extrapleural Space in Chronic Tuberculous Empyema: CT–Pathologic Correlation

2001 ◽  
Vol 25 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Hyae Young Kim ◽  
Koun-Sik Song ◽  
Ho Jung Lee ◽  
Jin Seong Lee ◽  
Tae-Hwan Lim
Keyword(s):  
Parietal Pleura ◽  
Pathologic Correlation

Biomechanics of human parietal pleura in uniaxial extension

2017 ◽  
Vol 75 ◽  
pp. 330-335 ◽  
Author(s):  
Luis E. Morales Tenorio ◽  
Kelsey J. Devine ◽  
Jayme Lee ◽  
Timothy M. Kowalewski ◽  
Victor H. Barocas
Keyword(s):  
Uniaxial Extension ◽  
Parietal Pleura

scholarly journals Abstract P-32: Lung Structural Changes in Covid-19 Patients

2021 ◽  
Vol 11 (Suppl_1) ◽  
pp. S25-S26
Author(s):  
Valeriy Kartashev ◽  
Djamshid Mardonov ◽  
Bahshillo Mamirov ◽  
Azamat Butaev
Keyword(s):  
Lung Tissue ◽  
Structural Changes ◽  
Ground Glass ◽  
Parietal Pleura ◽  
Lesion Volume ◽  
Autopsy Material ◽  
Severe Condition ◽  
Inflammatory Infiltration ◽  
Subsequent Transformation ◽  
Primary Diagnostics

Background: The main causes of death from Covid-19 are lung lesions with the development of respiratory failure. However, structural changes in the lung tissue in this pathology are poorly studied. We examined autopsy material from patients with Covid-19. The severe condition of patients, the manifestation of pulmonary symptoms of damage (cough, dyspnea) and the high probability of viral pneumonia at COVID-19 led to the widespread use of CT diagnostics in this group of patients, which allowed to identify of the primary signs of the disease, their subsequent transformation as well as the most adverse radiation symptoms corresponding to the severe course of the process (Speranskaya, 2020; Pan et al., 2019). In the cases studied by us, the detection of typical symptoms revealed by radiation diagnostics of COVID-19 was subsequently confirmed by PCR data, which may indicate a high information content and specificity of detecting CT symptoms of a lesion as a method of primary diagnostics. The aim of our study is to confirm at the microscopic level the correspondence of MSCT changes. Methods: The material was taken at autopsy of deceased patients, fixed in 10% formalin solution in phosphate buffer, paraffin sections were stained with hematoxylin and eosin. The autopsy material was examined using a Carl Zeiss light microscope, Axioskop 40. Results: Studies have shown that most of the alveoli of the lung tissue kept their airiness. However, their lumens were significantly reduced due to a significant thickening of the interalveolar septa caused by pronounced inflammatory infiltration mainly by lymphocytes. The most significant changes were revealed from the side of the microvasculature. There are numerous blood clots of various sizes in the lumen of most micro-vessels. The walls of microvessels have been significantly thickened with pronounced inflammatory infiltration and significant edema. The lumens of microvessels have been characterized by significant polymorphism. Intraluminal clots have been also characterized by pronounced polymorphism. The parietal pleura has been thickened. This has been reflected in the MSCT images and corresponds to the processes of perivascular infiltration. Conclusion: The primary CT pattern of COVID-19 is a picture of infiltration of individual secondary pulmonary lobules of the "ground glass" type, followed by a decrease in the lesion volume at a favorable course of the disease, or their increase, the addition of a CT picture of a "cobblestone pavement" and the appearance of alveolar infiltration in the area of "ground glass" at the unfavorable course of the disease.

scholarly journals Diagnostic Value of Flexible Thoracoscopy in Undiagnosed Cases of Exudative Pleural Effusion

2020 ◽  
Vol 7 (47) ◽  
pp. 2783-2786
Author(s):  
Vengada Krishnaraj S.P. ◽  
Gayathri S. Mohan ◽  
Vinod Kumar V ◽  
Sridhar R
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Complete Blood Count ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Parietal Pleura ◽  
Pleural Biopsy ◽  
Cardiac Evaluation ◽  
Exudative Pleural Effusion ◽  
Fluid Cytology

BACKGROUND The diagnostic yield of thoracoscopy is 95 %, of pleural fluid cytology it is 62 % and of closed pleural biopsy is 44 %, in malignant effusion. We wanted to study the diagnostic utility of flexible thoracoscopy in undiagnosed exudative pleural effusion and compare the thoracoscopy findings with the histopathology results. METHODS The study was conducted in the Department of Respiratory Medicine, Government Stanley Medical College, Chennai, from January 2019 to January 2020. 40 patients were enrolled in this longitudinal observational study with moderate to massive effusion and were evaluated with pleural fluid aspiration and sent for cytology, protein sugar analysis, total count, and ADA. Those cases which are exudative pleural effusions, with ADA value of less than 40 IU / L were subjected to thoracoscopy after being evaluated for fitness for thoracoscopy with complete blood count, bleeding time, clotting time, sputum for AFB, ECG, pulse oximetry, cardiac evaluation and CT chest. RESULTS Thoracoscopy was done in 40 enrolled patients. In this study, biopsy was taken from the parietal pleura in all the cases. Of these 40 cases, 30 were male and 10 were female, that is 75 % males and 25 % females. The mean age of the study population was 43 ± 14.9. Patient with the lowest age in this study group was 18 years and highest was 71 years. 16 cases (40 %) presented with left sided pleural effusion. 24 cases (60 %) presented with right sided pleural effusion. 30 cases presented with massive effusion, and 10 cases with moderate effusion. Of the 40 cases, 27 cases presented with straw coloured pleural effusion. 13 cases were haemorrhagic effusion. Histopathologic examination showed 11 cases as malignant and 29 cases as non-malignant out of which 18 cases were of tuberculosis aetiology. Thoracoscopy revealed adhesions in 13 cases and mass lesion in 4 cases. Of the 4 mass lesions 3 came as malignant, normal pleura in 11 cases, 10 were non-malignant and 1 was malignant. Nodules were seen in 12 cases of which 7 came as malignant. Straw coloured effusion was seen in 27 cases, of which 2 were malignant. CONCLUSIONS The most important indication for thoracoscopy is exudative undiagnosed pleural effusion. The overall diagnostic yield in pleural fluid cytology is 62 % and blind pleural biopsy is 44 %. The diagnostic yield of thoracoscopy varies from 60 % to 97 % in various studies, whereas, in our study, it is 72.5 %. Visualization of the visceral and parietal pleura is another advantage, so that we can take biopsy from the abnormal areas. KEYWORDS Flexible Thoracoscopy, Undiagnosed Exudative Pleural Effusion

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