Benign and malignant pleural interactions - evaluation by computed tomography

In this work 153 tomographic examinations of thorax were analyzed, including 82 neoplastic patients found at Instituto Nacional de Cancer, Rio de Janeiro, and 71 nonneoplastic patients from Hospital Universitario Antonio Pedro, Niteroi. According to the specific tomographic signs, pleural alterations were classified into free-effusion, loculated effusion, pleural thickening, subpleural thickening tumor mass and pneumothorax. These groups were correlated to causal illnesses and histopathologic data found in the patient's records. Similar free-effusion proportional cases were found among neoplastic and nonneoplastic patients. Loculated effusion occurred mainly among nonneoplastic patients, the majority being related to infectious pneumopathies and in a large amount to pleural manipulations. Pleural thicknenings were classified into plain, spiculated and nodular groups. Plain pleural thickenings were found in a larger percentual related to loculated effusion. Spiculated pleural thicknenings were observed in chronic pneumopathy reactional processes. Pneumothoraxes, in a large majority, were due to the rupture of subpleural bulla. (author)