An Unsupervised Parametric MixtureModel for Automatic Three-DimensionalLung Segmentation
Ayman El-Baz, Jasjit S. Suri in Lung Imaging and CADx, 2019
Figure 13.3 shows a cross-sectional view for the lungs. Each lung is covered with glistening visceral pleura, which has a translucent nature. This pleura looks pink, and it may accumulate black pigment due to age because of the exposure to environment particulates [5]. The pleura that covers each lung is a membrane consisting of two main layers: the visceral pleura and the parietal pleura. The visceral pleura extends into the lung fissures and forms invaginations into both lungs, while the parietal pleura connects the diaphragm and the mediastinum by the thoracic wall. The main function of the lung pleura is to reduce the friction between lung layers during the breathing process, to maintain the position of the lungs within the chest wall [3], and to produce the pulmonary ligament that holds the lungs over the diaphragm [6].
Radiologic Diagnosis of Pleural Disease
Philip T. Cagle, Timothy C. Allen, Mary Beth Beasley in Diagnostic Pulmonary Pathology, 2008
The word pleura comes from the Greek word pleura meaning “the side of the body or the ribs.” The parietal pleura lines the thoracic cavity and the visceral pleura lines the lungs, following each lobe intimately. This thin layer of tissue develops after the 24th week of gestation from splanchnic mesenchyme, which grows to join the body wall mesenchyme and in turn becomes contiguous with the parietal pleura, which is derived from somatic mesoderm. Visceral pleura lines the interior aspect of the thoracic cavity, upper aspect of the diaphragm, spine, and lateral mediastinal wall. Because of normal hydrostatic pressures in the parietal pleural vasculature, capillary leakage produces pleural fluid at the rate of 0.01 mL/kg of body weight per hour. The parietal pleural lymphatic system absorbs this fluid and returns it to the systemic circulation via the thoracic duct. Under normal physiologic conditions, approximately 10 mL of pleural fluid occupies the pleural space and provides lubrication for the two tissue layers to slide past one another during the continuous morphing of the lung due to respiration.
Embryology, anatomy, and histology of the lung
Louis-Philippe Boulet in Applied Respiratory Pathophysiology, 2017
The lungs have a dual blood supply: pulmonary and systemic. The pulmonary circulation is a low-pressure system (on average about 15 mmHg), which is dependent on the right side of the heart and whose role is to oxygenate blood. In contrast, the systemic circulation is a high-pressure system (100 mmHg) that depends on the left side of the heart and whose role is to distribute oxygenated blood to the whole body. The pulmonary arteries are part of the pulmonary circulation and accompany bronchi in their subdivisions to achieve a rich capillary network that surrounds the alveolar walls to maximize the gas exchange area between blood and air. Bronchial arteries are part of the systemic circulation and come either from the aorta or intercostal arteries. They form a plexus in the bronchial wall, which extends to the terminal bronchioles. Proximally, they anastomose to the inferior thyroid artery-dependent tracheal arterial network. Branches of the bronchial arteries also provide vascularization of the visceral pleura. Pulmonary veins start when efferent pulmonary capillaries form small veins (venules) in the interlobular septa. On histological sections, pulmonary arteries are centrobular accompanying a bronchiole having approximately the same size and veins are at the lobule periphery either in interlobular septa or the pleura.
Risk factors associated with fetal pleural effusion in prenatal diagnosis: a retrospective study in a single institute in Southern China
Published in Journal of Obstetrics and Gynaecology, 2020
Xin Yang, Dan Yang, Qiong Deng, Fu Fang, Jin Han, Li Zhen, Dongzhi Li, Can Liao
Fetal pleural effusion is a rare condition with an incidence of approximately 1 in 15,000 newborns (Longaker et al. 1989). It mainly refers to an accumulation of fluid in the pleural space, which exists between the parietal pleural of the chest wall and the visceral pleura of the lung. The prognosis of fetal pleural effusion is difficult to predict with various perinatal mortality rates between 22 and 53% (Weber and Philipson 1992 ; Aubard et al. 1998; Klam et al. 2005). The aetiology of fetal pleural effusion includes chromosomal abnormality, congenital heart disease, congenital infections and a number of genetic syndromes (Bellini et al. 2013; Ruano et al. 2011; Rustico et al. 2007). It has been reported that about 41 to 80% of foetuses with pleural effusion are identified with chromosomal abnormalities (Waller et al. 2005), but most of these cases were diagnosed in the first trimester. For those cases which were in the second or third trimester, the aneuploidy rates only ranged from 3.2 to 5.8% (Hashimoto et al. 2003). The aim of this study was to analyse the factors associated with a fetal pleural effusion in a single institute in the South of China.
Making cold malignant pleural effusions hot: driving novel immunotherapies
Published in OncoImmunology, 2019
Pranav Murthy, Chigozirim N. Ekeke, Kira L. Russell, Samuel C. Butler, Yue Wang, James D. Luketich, Adam C. Soloff, Rajeev Dhupar, Michael T. Lotze
Pleural mesothelial cells (PMCs) reside within the parietal and visceral pleura and are essential to pleural homeostasis. Dysregulation of PMC responses leads to activation and formation of MPE.65 Pleural cavity injury during infection, trauma, or malignancy is initially recognized by PMCs and results in a response-specific inflammatory cascade.65 In addition to their negatively charged surface glycoconjugates that limit errant cells,66 PMCs express TLRs 1–967 and mediate inflammation via release of platelet derived growth factor (PDGF), interleukin-8 (IL-8), monocyte chemotactic peptide (MCP-1), and nitric oxide.68 Sialidases on malignant cells remove the defensive sialomucin complex layer on PMCs.66 Release of vascular endothelial growth factor (VEGF) increases permeability of PMCs, allowing for leakage of high molecular weight proteins, promoting migration of cells into the pleural space.65,69 A retrospective analysis of 21 patients with NSCLC associated MPE treated with bevacizumab, an anti-VEGF antibody, and chemotherapy demonstrated a remarkable 71.4% response rate of MPE to antibody treatment.70
Bilateral pneumatoceles resulting in spontaneous bilateral pneumothoraces and secondary infection in a previously healthy man with COVID-19
Published in Baylor University Medical Center Proceedings, 2021
Piruthiviraj Natarajan, James Skidmore, Olufemi Aduroja, Vamsi Kunam, Dan Schuller
Acute or chronic lung infection, mechanical ventilation, lung trauma, or aspiration of certain hydrocarbons can result in pneumatoceles.8 In COVID-19 pneumonia, late development of multiple pneumatoceles with rupture causing bilateral pneumothoraces, pneumomediastinum, and subcutaneous emphysema is a rare complication, particularly in patients who did not require positive pressure ventilatory support.9 Lung compliance is severely affected after COVID-19 pneumonia, and patients with lower compliance were found to have higher mortality rates.5 As seen in our patient, the development of pulmonary necrosis leading to pneumatoceles or cavitary lung lesions can cause hemoptysis, and if disruption of the visceral pleura occurs can result in life-threatening pneumothoraces. About 85% of all patients with pneumatoceles recover spontaneously, whereas some critically ill patients warrant surgical resection.2,6 Our patient was treated successfully with a prolonged course of IV and oral antimicrobial therapy, consistent with standard treatment recommendations for lung abscess.7
Related Knowledge Centers
- Coelom
- Invagination
- Serous Membrane
- Thoracic Wall
- Lung
- Mediastinum
- Thoracic Cavity
- Lung Bud
- Animal Embryonic Development
- Pericardium