THORACIC Section 14: Pleura, Chest Wall Flashcards
If they show you a pleural plaque, they probably want to say what related type of disease?
Asbestos-related
Asbestos plaques show up how many years after exposure?
20-30 years.
Most common cancer of the pleura.
Malignant Mesothelioma.
Key features of Malignant Mesothelioma?
Circumferential pleural thickening extending ot the meedial surface of the pleura. Near the hear.
Malignant Mesothelioma that is highly suggestive of the disease?
Fissural extension.
If the lateral pleural is thick? Most common cause is?
Prior trauma. Look for rib fractures.
If the medial pleural is thick, think of what diseasE?
Mesothelioma
A solitary (usually) tumor with no association with environmental exposures?
Solitary Fibrous Tumor of the Pleura
What pleura does SFTP arise?
Visceral
What syndrome is SFTP associated?
Doege-Potter Syndrome
This is an episodichypoglycemia (tumor can
secrete an insulin like growth factor
This disease occurs in 30% of teh SFTP cases.
Hypertrophic Osteoarthorpathy
Most common benign soft tissue of the pleura.
Lipoma.
What neoplasm is likely to metastasize in the pleura?
AdenoCA
2nd and 3rd most common primary in the pleural metastasis?
2nd - breast
3rd - lymphoma
Most common manifestation of metastasis to the pleura.
Pleural effusion.
Volume of fluid to be seen in frontal veiw xray.
175 cc.
Volume of fluid to be seen in lateral xray.
75 cc
Pleural fluid accumulating between the lung base and diaphragm
Subpulmonic effusion
Sign of subpulmonic effusion on frontal xray?
Lateralization of the diaphragmati cpeak.
Basically this is an infected pleural effusion
Empyema
Empyema can occur with a simple pneumonia but is more in people with what condition?
AIDS
When the empyema eats through the chest wall and into the soft tissues.
Empyema Necessitans
Empyema Necessitans is seen in this condition (70%)
TB
2nd most common cause of Empyema necessitans
Actinomyces
Most common congenital diaphragmatic hernia
Bochdalek
Posterior diaphragmatic hernia
Bochdalek (BACKdalek)
Anterior diaphragmatic hernia
Morgagni
Most common laterality on traumatic diaphragmatic henria
Left (Liver is a buffer)
Abscess vs Epyema
Lentiform + Split Pleural sign (Thickening and separation of the visceral and parietal pleura) + CTT
Empyema
Abscess vs Empyema
Round + Claw Sign (Acute angle with pleura) + No treated with CTT
Pulmonary abscess
Risk of CTT on pulmonary abcess
Bronchopleural fistula
Common cause of diaphragmatic paralysis
Idiopathic (70%)
Phrenic nerve compression from a lung cancer
What should you look for in a sniff test on diaphragmatic paralysis?
Paradoxial movement (up on inspiration - instead of down)
