Thursday, October 22, 2009

Pleural thickening

45 year old man with previous history of tuberculosis presented with shortness of breath. Chest x-ray showed thickened right lower pleural wall with blunting of right costo-phrenic angle.
Tuberculosis is the most common cause in the Asian context. However, pleural thickening may follow any form of inflammatory process of the pleura such as effusion, empyema, haemothorax, asbestosis, rheumatoid lung, radiation therapy and drugs.
It may also be due to infiltration of the pleural by malignant tumours such as mesothelioma and metastatic adenocarcinoma.
Ultrasound will be useful to differentiate thickening from loculated pleural effusion or empyema.

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