370.Pleural Effusion

每天朗读一段医学影像学英语文章

-Pleural effusion is a condition characterized by abnormal fluid collection between the parietal and visceral pleura (excess pleural space fluid). The pleural fluid can be water (edematous effusion), blood (hemothorax), pus (empyema), tumor cells (malignant pleural effusion), or lymph (chylothorax).

-Pathologically, pleural effusion is divided into serous or exudative according to the protein content after lab analysis. Serous plural effusion contains little protein content (<2.5 g/dL) and usually arises due to systemic disease like cardiac failure, nephrotic syndrome, or liver failure. Exudative pleural effusion contains high protein count (>2.5 g/dL) and usually arises due to inflammatory or infectious process like tuberculosis, malignancy, and acute pancreatitis.

-Disruption of the thoracic duct due to lymphoma or a tumor can cause lymphatic blockage and leakage into the pleural space causing chylothorax. Malignant effusion typically results from metastasizing of the malignant cells into the pleural cavity via the parietal pleura lymphatics, and it is often massive.

Bronchopleural fistula is a condition characterized by opening of a bronchus into the pleural space. It can develop occasionally following thoracic surgery, infection, medical intervention, or malignancy. Bronchopleural fistula is seen in 2–3 % of postpneumonectomy cases.

Obliteration of the lateral costophrenic angle with a meniscus like arc at the interface between the fluid and the chest wall in PA radiographs (Meniscus sign) (Fig. 7.1.1).

Obliteration of the posterior costophrenic angle in lateral radiographs (Fig. 7.1.1). This angle is more sensitive to plural effusion collection due to gravity effect.

Fig. 7.1.2 Posteroanterior chest radiograph of a patient with right subpulmonic pleural effusion (SPE) shows raised hemidiaphragm, and the lung seems to end early (arrowhead)

Fig. 7.1.3 Posteroanterior (a) and lateral (b) chest radiographs show right-sided encysted pleural effusion (arrowheads). Encysted (loculated) pleural effusion is a localized encysted fluid at the fissures between lobes of the lung. It occurs usually at the right lung’s minor fissure, and it has biconvex contour mimicking a mass .

Notes:

1.chylothorax /ˌkailəu'θɔ:ræks//ˌkailəu'θɔ:ræks/ n. 乳糜胸

2.serous /'sɪərəs//'sirəs/ adj.浆液(状)的,血浆的,含浆液的

3.Exudative /iɡ'zju:dətiv//iɡ'zju:dətiv/ adj. 渗出(性)的;流出(性)的

4.postpneumonectomy  肺切除术后

5.encysted /en'sɪstɪd//en'sɪstɪd/ adj. 被囊的；包绕的；具硬壳的

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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