Rounded atelectasis of the lung: A pictorial review

Sobocińska, Magdalena; Sobociński, Bartosz; Jarzemska, Agnieszka; Serafin, Zbigniew

doi:10.12659/pjr.889983

Cited by 18 publications

(43 citation statements)

References 10 publications

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“…Rounded atelectasis is more common in men (80%) than in women. The most common cause of rounded atelectasis (RA) is occupational exposure to asbestos [ 29 , 30 ]. The direct mechanism for the development of rounded atelectasis has not been fully explained.…”

Section: Discussionmentioning

confidence: 99%

“…The direct mechanism for the development of rounded atelectasis has not been fully explained. According to one of the theories [ 29 ], pleural fluid causes local atelectasis due to the pressure on the adjacent lung. If the rate of fluid pleural accumulation exceeds the absorptive capacity of adjacent alveoli, visceral pleura damage occurs with formation of a fissure and translocation of the lung towards that fissure.…”

Section: Discussionmentioning

confidence: 99%

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Rounded atelectasis after exposure to refractory ceramic fibres (RCF)

et al. 2021

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Background Refractory Ceramic fibres (RCF) are man-made mineral fibres used in high performance thermal insulation applications. Analogous to asbestos fibres, RCF are respirable, show a pleural drift and can persist in human lung tissue for more than 20 years after exposure. Pleural changes such as localised or diffuse pleural thickening as well as pleural calcification were reported. Result A 45 years old man worked in high performance thermal insulation applications using refractory ceramic fibres (RCF) for almost 20 years. During a occupational medical prophylaxis to ensure early diagnosis of disorders caused by inhalation of aluminium silicate fibres with X-ray including high-resolution computed tomography (HRCT), bilateral pleural thickening was shown and a pleural calcification next to a rounded atelectasis was detected. Asbestos exposure could be excluded. In pulmonary function test a restrictive lung pattern could be revealed. In work samples scanning electron microscopy (SEM) including energy dispersive X-ray analysis (EDX) classified used fibres as aluminium silicate fibres. X-ray powder diffraction (XRD) and transmission electron microscopy (TEM) showed crystalline as well as amorphous fibres. Conclusions A comprehensive lung function analysis and in case of restrictive lung disorders additional CT scans are needed in RCF exposed workers in accordance to the guidelines for medical occupational examinations comparable to asbestos exposed workers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rounded atelectasis after exposure to refractory ceramic fibres (RCF)

et al. 2021

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“…Atelectasis is the collapse or closure of a lung, resulting in reduced or absent gas exchange, which is caused by various lung diseases such as inflammatory nodules, tuberculosis, asthma, chronic obstructive pulmonary disease, and bronchiectasis, resulting in mechanical alveolar obstruction . Clinically significant atelectasis is generally identified by preoperative chest radiography or CT scan . Therefore, based on the results of a preoperative CT scan, surgeons can accurately identify the tumor, benign lung lesion, or atelectasis in the operative field.…”

Section: Discussionmentioning

confidence: 99%

“…44 Clinically significant atelectasis is generally identified by preoperative chest radiography or CT scan. 45 Therefore, based on the results of a preoperative CT scan, surgeons can accurately identify the tumor, benign lung lesion, or atelectasis in the operative field. In addition, chest physiotherapy bronchodilators, fiberoptic bronchoscopy, positive end-expiratory pressure, and surfactants have been described by many researchers as treatment modalities for atelectasis and shown to be effective in the resolution of atelectasis.…”

Section: Limitationsmentioning

confidence: 99%

Evaluation of Intraoperative Near-Infrared Fluorescence Visualization of the Lung Tumor Margin With Indocyanine Green Inhalation

Jung

et al. 2020

JAMA Surg

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Identification of the tumor margin during surgery is important for precise minimal resection of lung tumors. Intravenous injection of indocyanine green (ICG) has several limitations when used for intraoperative visualization of lung cancer.OBJECTIVES To describe a technique for intraoperative visualization of lung tumor margin using ICG inhalation and evaluate the clinical applicability of the technique in mouse and rabbit lung tumor models as well as lung specimens of patients with lung tumors. DESIGN, SETTING, AND PARTICIPANTSIn lung tumor models of both mice and rabbits, the distribution of inhaled ICG in the lung tumor margin was investigated in vivo and ex vivo using a near-infrared imaging system. Lung tumor margin detection via inhalation of ICG was evaluated by comparing the results obtained with those of the intravenous injection method (n = 32, each time point for 4 mice). Based on preclinical data, use of ICG inhalation to help detect the tumor margin in patients with lung cancer was also evaluated (n = 6). This diagnostic study was conducted from May 31, 2017, to March 30, 2019. MAIN OUTCOMES AND MEASURESThe use of tumor margin detection by inhaled ICG was evaluated by comparing the inhaled formulation with intravenous administration of ICG. RESULTSFrom 10 minutes after inhalation of ICG to 24 hours, the distribution of ICG in the lungs was significantly higher than that in other organs (signal to noise ratio in the lungs: 39 486.4; interquartile range [IQR], 36 983.74-43 592.5). Ex vivo and histologic analysis showed that, in both lung tumor models, inhaled ICG was observed throughout the healthy lung tissue but was rarely found in tumor tissue. The difference in the fluorescent signal between healthy and tumor lung tissues was associated with the mechanical airway obstruction caused by the tumor and with alveolar macrophage uptake of the inhaled ICG in healthy tissues. Inhalation at a 20-fold lower dose of ICG had a 2-fold higher efficiency for tumor margin detection than did the intravenous injection (2.9; IQR, 2.7-3.2; P < .001). CONCLUSIONS AND RELEVANCEThe results of this study suggest that lung-specific inhalation delivery of ICG is feasible and may be useful for the intraoperative visualization of lung tumor margin in clinical practice.

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“…Rounded atelectasis (also called atelectatic pseudotumor, folded lung, or Blesovsky syndrome) is a condition extensively reported in human medicine, which describes focal, peripheral lung collapse caused by pleural adhesions and fibrosis secondary to chronic pleural effusions and pleuritis. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] This condition was first published in the 1960s by Blesovsky who reported that peripheral pulmonary nodules sampled during thoracotomies in humans frequently resembled benign folded lung, which initiated research endeavors for defining the imaging characteristics, etiologies, and pathophysiology of this condition. [1][2][3] Asbestos inhalation is the most documented factor associated with this condition in humans, although all types of pleural effusion can potentially induce it.…”

Section: Introductionmentioning

confidence: 99%

CT features of rounded atelectasis in chronic inflammatory pleural effusions in cats and dogs

Tran

Donovan

Daverio

et al. 2023

Vet Radiology Ultrasound

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Rounded atelectasis is well described in human medicine as focal lung deformation and collapse secondary to inflammatory pleural effusions and pleuritis. Specific CT features (round to ovoid soft tissue pulmonary attenuations, creation of an acute angle with the adjoining visceral pleura, and the presence of perinodular comet tail signs) support the diagnosis of rounded atelectasis in humans so that further diagnostic workup is not necessary in defining the nodules. In this retrospective case series, we described the CT characteristics of rounded atelectasis in eight cats and three dogs diagnosed with restrictive pleuritis secondary to either a chylothorax or pyothorax. Thirty-six soft tissue attenuating pulmonary nodular lesions were identified on CT. Comet tail signs, consisting of bundles of bronchi and vessels coalescing into the pulmonary nodules, were associated with 92% of the nodules (33/36), and 92% of the nodules abutted and created an acute angle with the pleura (33/36). Other prevalent features included location in gravity-dependent regions of the lung lobes (33/36, 92%), blurred hilar margins with sharper pleural margins of the nodules (33/36, 92%), presence of air bronchograms (30/36, 83%), homogeneous contrast-enhancement (23/36, 64%), and volume loss of the affected lung lobe (22/36, 61%). Pulmonary malignant neoplasms were not found cytologically (6/11 patients) or histologically (5/11 patients). To avoid a misdiagnosis of neoplasia, veterinary radiologists should be aware of the CT features of rounded atelectasis and consider it as a differential for pulmonary nodular lesions in patients with concurrent inflammatory pleural effusion and pleuritis.

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Rounded atelectasis of the lung: A pictorial review

Cited by 18 publications

References 10 publications

Rounded atelectasis after exposure to refractory ceramic fibres (RCF)

Rounded atelectasis after exposure to refractory ceramic fibres (RCF)

Evaluation of Intraoperative Near-Infrared Fluorescence Visualization of the Lung Tumor Margin With Indocyanine Green Inhalation

CT features of rounded atelectasis in chronic inflammatory pleural effusions in cats and dogs

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