Document Detail


CT of pleural abnormalities in lymphangioleiomyomatosis and comparison of pleural findings after different types of pleurodesis.
MedLine Citation:
PMID:  16554571     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of our article was to describe the spectrum and frequency of pleural abnormalities on CT in patients with lymphangioleiomyomatosis (LAM) and the pleural findings associated with different types of pleurodesis (talc, mechanical, and chemical) performed to treat the complications of pleural disease in these patients. MATERIALS AND METHODS: Two hundred fifty-eight patients with LAM underwent CT of the chest. Pleural abnormalities assessed included pleural thickening, presence of a pleural mass, areas of high attenuation, effusion, and pneumothorax. In patients who had had pleurodesis, the CT findings were correlated with the type of procedure performed. RESULTS: One hundred thirty-three (52%) of 258 patients had pleurodesis (unilateral, 68/133; bilateral, 65/133). Pleural abnormalities were more common in patients who had pleurodesis (101/133, 76%) than in those who had not (47/125, 38%) and were more prevalent on the operated side than on the unoperated side of those 68 patients who had unilateral pleurodesis. The frequencies of findings for the group without pleurodesis versus the group with pleurodesis were pleural thickening (26% vs 65%), effusion (10% vs 13%), loculated effusion (2.4% vs 11%), pneumothorax (1.6% vs 10%), areas of high attenuation (1.6% vs 23%), and mass (0.8% vs 14%), respectively. Areas of high attenuation in the pleura were present in all types of pleurodesis (mechanical, 8%; chemical, 13%; talc, 40%) and in two patients who had had repeated thoracentesis or pleurectomy. Pleural masses were present in patients who had had all types of pleurodesis (mechanical, 10%; chemical, 9%; talc, 24%) and in one patient who had had thoracentesis and thoracostomy; the masses commonly enhanced and did not change in size over time. CONCLUSION: Pleural abnormalities are common in patients with LAM as complications of the disease itself and as sequelae of pleurodesis and other pleura manipulations. Pneumothorax and pleural effusion result from the underlying pathophysiology of LAM, whereas areas of high attenuation and masses develop after all types of pleurodesis and other manipulations of the pleura (i.e., thoracentesis, thoracostomy).
Authors:
Nilo A Avila; Andrew J Dwyer; Antoinette Rabel; Rosamma M DeCastro; Joel Moss
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  186     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-23     Completed Date:  2006-05-30     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1007-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic Radiology, Warren G. Magnuson Clinical Center, Bldg. 10, Rm. 1C-660, 10 Center Dr., MSC 1182, Bethesda, MD 20892-1182, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Lymphangioleiomyomatosis / complications*,  therapy*
Middle Aged
Pleural Diseases / etiology*,  radiography*
Pleural Effusion, Malignant / etiology*,  radiography*
Pleurodesis* / methods
Tomography, X-Ray Computed*

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