No abstract available.
Pleural Diseases*

No abstract available.
Pleural Diseases* ; Thoracoscopy*

No abstract available.
Diagnosis* ; Pleural Diseases*

Calcifying fibrous pseudotumors (CFP) are rare soft tissue tumors that have unique histopathologic features characterized by a dense hyalinized collagenous tissue interspersed with benign spindle cells, lymphoplasmacytic infiltrate, and psammomatous or dystrophic calcifications. We report here on a case of calcifying fibrous pseudotumors in the pleura and provide a literature review.
Collagen ; Hyalin ; Pleura ; Pleural Diseases

Introduction: Dermatomyositis is an autoimmune inflammatory process typically presenting with symmetric proximal muscle weakness preceded by skin lesions. We report a case of dermatomyositis initially presenting with pleural effusion before developing rashes and proximal muscle weakness. Case presentation: A 46-year-old female with no known comorbidities presented with four weeks of anorexia. On work-up, she was found to have bilateral pleural effusion. Diagnostic and therapeutic thoracentesis done draining one liter. Pleural fluid analysis showed exudative character with no presence of bacteria or malignant cells. Intravenous piperacillin-tazobactam 4.5g every eight hours was given for one week but effusion persisted. After 10 days of intravenous antibiotic, antibiotic was shifted to oral cefixime 400mg tab once daily and levofloxacin 500mg tab once daily. However patient developed maculopapular rashes over the face, neck and arms two days after starting the oral antibiotics. The antibiotics were withheld and antihistamine was given for possible drug reaction. No improvement thus oral prednisone 20mg/day for six days was given. After 14 days of oral prednisone, rashes persisted, now with proximal muscle weakness in all extremities associated with the ‘V-sign’ and ‘shawl sign’. The patient was readmitted and work-up showed resolution of pleural effusion. ANA was positive and CKMM level was markedly high. Other rheumatologic tests were unremarkable. Patient was started on Intravenous hydrocortisone 200mg/day and methotrexate 7.5mg/ day once a week. Nine days after initiating intravenous glucocorticoid and methotrexate, patient’s symptoms resolved. Patient was advised for malignancy work-up on follow-up but was lost to follow-up. Discussion: Dermatomyositis initially presents with rashes (100%) and proximal myopathy (95.2%). Interstitial lung disease (ILD) may occur (28.6%), but pleural involvement is rare with only three reported cases and all were associated with ILD. There are no reports of pleural effusion as the initial manifestation. Dermatomyositis is confirmed using the Bohan and Peter Criteria and our patient fulfilled a definitive diagnosis. Glucocorticoids and immunosuppressive drugs are mainstay treatment. Pleural effusion involvement was observed to have good response to treatment, in contrast to ILD which was associated with higher mortality thus should be ruled out in patients with pleural effusion. Conclusion Autoimmune diseases are known for classic manifestations, but may rarely mimic common clinical manifestations thus high index of suspicion is warranted to provide prompt management.
Dermatomyositis ; Pleural Effusion ; Autoimmune Diseases

Pleural effusion is not a rare disease in Korea. The diagnosis of pleural effusion is very difficult, even though the patients often complain of typical symptoms indicating of pleural diseases. Pleural effusion is characterized by the pleural cavity filled with transudative or exudative pleural fluids, and it is developed by various etiologies. The presence of pleural effusion can be confirmed by radiological studies including simple chest radiography, ultrasonography, or computed tomography. Identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments. This review article provides information on the diagnostic approaches of pleural effusions and further suggested ways to confirm their various etiologies, by using the most recent journals for references.
Diagnosis ; Humans ; Korea ; Pleural Cavity ; Pleural Diseases ; Pleural Effusion* ; Pleurisy ; Radiography ; Rare Diseases ; Thorax ; Ultrasonography

BACKGROUND: A pleural effusion is not a disease entity but a clincial sign of systemic or pleural disease. Although the diagnosis of pleural effusion can often be done by toracentesis and pleural needle biopsy the yeild of positive diagnosis is low.
Biopsy, Needle ; Diagnosis ; Pleural Diseases ; Pleural Effusion* ; Thoracoscopy*

PURPOSE: To determine through an analysis of the location of pleural effusion associated with ascites, as seen on abdominal CT scan, differences in the distribution of pleural effusion according to the etiology and distribution of ascites. MATERIALS AND METHODS: We retrospectively evaluated 77 consecutive patients in whom abdominal CT scan revealed pleural effusion associated with ascites. Patients with history of surgery or trauma and those with clinically and radiologically diagnosed lung or pleural diseases were excluded. We compared the location of pleural effusion with the etiology and distribution of ascites. RESULTS: Forty-two patients were suffering from hepatobiliary diseases, mainly right dominant pleural effusion (26/42, 62%). Fourteen had intraperitoneal carcinomatosis with no significant difference between the frequency of right dominant (5/14, 36%)and of left dominant (6/14, 43%) pleural effusion. Eleven patients had pancreatic diseases, with mainly left dominant pleural effusion (6/11, 55%). Patients with right dominant ascites usually had right dominant pleural effusion (22/24, 92%) and those with left dominant ascites had left dominant pleural effusion (9/10, 90%). CONCLUSION: Ascites-associated pleural effusion correlated with the anatomical location of the etiology of ascites ; its laterality was, in addition, usually the same as that of ascites.
Ascites* ; Carcinoma ; Humans ; Lung ; Pancreatic Diseases ; Pleural Diseases ; Pleural Effusion* ; Retrospective Studies ; Tomography, X-Ray Computed*

BACKGROUND: A closed pleural biopsy is commonly performed for diagnosing patients exhibiting pleural effusion if prior thoracentesis is not diagnostic. However, the diagnostic yield of such biopsies is unsatisfactory. Instead, a thoracoscopic pleural biopsy is more useful and less painful. METHODS: We compared the diagnostic yield of needle thoracoscopic pleural biopsy performed under local anesthesia with that of closed pleural biopsy. Sixty-seven patients with pleural effusion were randomized into groups A and B. Group A patients were subjected to closed pleural biopsies, and group B patients were subjected to pleural biopsies performed using needle thoracoscopy under local anesthesia. RESULTS: The diagnostic yields and complication rates of the two groups were compared. The diagnostic yield was 55.6% in group A and 93.5% in group B (p<0.05). Procedure-related complications developed in seven group A patients but not in any group B patients. Of the seven complications, five were pneumothorax and two were vasovagal syncope. CONCLUSION: Needle thoracoscopic pleural biopsy under local anesthesia is a simple and safe procedure that has a high diagnostic yield. This procedure is recommended as a useful diagnostic modality if prior thoracentesis is non-diagnostic.
Anesthesia, Local* ; Biopsy* ; Humans ; Needles* ; Pleural Diseases ; Pleural Effusion* ; Pneumothorax ; Syncope, Vasovagal ; Thoracoscopy

A pseudochylothorax, a chyliform pleural effusion, is a rare disease of pleural effusion that contains cholesterol crystals or high lipid content that is not the result of a disrupted thoracic duct. Most of the cases were found in patients with long-standing pleural effusion due to chronic inflammatory disease, such as old tuberculous pleurisy or chronic rheumatoid pleurisy. We experienced a case of pseudochylothorax in a 74-year-old man, who was being treated for pulmonary tuberculosis and pleurisy 10 years ago. The diagnosis was confirmed on pathological study of the pleural effusion, which contained cholesterol crystals having a diagnostic rhomboid appearance.
Aged ; Cholesterol ; Humans ; Pleural Effusion ; Pleurisy ; Rare Diseases ; Thoracic Duct ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary