Pathology of the Pleura and Mediastinum

2018 Edition
| Editors: Timothy Craig Allen, Saul Suster

Fibrous Pleural Adhesions

  • Emma Henrie
  • Timothy Craig AllenEmail author
Reference work entry


Adhesions; Fibrous pleural adhesions; Pleural adhesions


Fibrous pleural adhesions are common after any surgical procedure affecting the pleural space. Adhesions form from one pleural surface across to the other pleural surface. The adhesion is generally composed of delicate strands of fibrous tissue.

Injury to the pleural surfaces induces an inflammatory reaction involving cellular elements, tissue factors, and coagulation factors. The early adhesion is made mostly of fibrin gel matrix, which is made of fibrin polymers reacting with fibronectin and amino acids. If the tissue plasminogen activator system does not remove the fibrin gel matrix and fibrinolysis does not occur, connective tissue scarring and adhesions develop from the ingrowth of fibroblasts. Fibrinolysis is impaired by, among other things, ischemia, foreign bodies, bacteria, desiccation, and thermal injury.

Fibrin is deposited at the site of injury fairly quickly after the trauma, and fibrin deposition...

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References and Further Reading

  1. Cassanelli, N., Caroli, G., Dolci, G., Deli’Amore, A., Luciano, G., et al. (2012). Accuracy of transthoracic ultrasound for the detection of pleural adhesions. European Journal of Cardio-Thoracic Surgery, 42, 813–818.CrossRefPubMedGoogle Scholar
  2. Montes, J., Garcia-Valero, J., & Ferrer, J. (2006). Evidence of innervation in talc-induced pleural adhesions. Chest, 130, 702–709.CrossRefPubMedGoogle Scholar
  3. Tanaka, K., Hida, Y., Kaga, K., Kato, H., Iizuka, M., et al. (2010). Video-assisted thoracoscopic surgery lowers the incidence of adhesion to the chest wall but not to the mediastinal and interlobar pleurae. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 20(1), 46–48.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyUniversity of Texas Medical BranchGalvestonUSA
  2. 2.Department of Pathology, The University of Mississippi Medical SchoolThe University of Mississippi Medical CenterJacksonUSA