Pleural Disease

Abstract

The pleural space, which normally contains approximately 10 mL of fluid on either side, can be a host to a variety of pathologic conditions. The most common process to affect this space is increased fluid volume, known as a pleural effusion. An effusion may have a variety of causes, and both imaging and laboratory evaluation are used to distinguish among these etiologies. Other collections in the pleural space include chylothorax, hemothorax, or pneumothorax, and these are also important to consider on radiologic and clinical workup. Primary pleural malignancies, while rare, can be life threatening, and imaging can play a large part in the diagnosis and management of these entities. The most common malignancy in the pleural space is metastatic disease. The most common primary pleural malignancy is mesothelioma, a deadly neoplasm that is most often associated with asbestos exposure. Other pleural neoplasms, including solitary fibrous tumor of the pleura, are even rarer. This chapter highlights the key concepts of pleural disease, illustrates radiologic examples of these conditions, and provides a background into each disease process.