Loculated transudate

Yıl 2020, Cilt: 45 Sayı: 3, 1263 - 1264, 30.09.2020

Uğur Gönlügür Tanseli Gönlügür Şule Özer

https://doi.org/10.17826/cumj.632447

Öz

The association between heart failure and phantom tumor has been well known for years. Because drainage mechanism exists in parietal pleura, phantom tumors generally localize between fissures. Loculated transudate in peripheral lung areas is extremely rare. We present an interesting case of encapsulated transudative pleural effusion associated with pneumonia. The pleural fissures, formed by a double layer of visceral pleura, represent extensions of the pleural space between lobes of the lungs. Localized transudative effusion between fissures, known as phantom tumor or vanishing tumor, can be seen during fluid overload. Because most pleural fluid drainage occurs through parietal pleural lymphatics , effusions tend to localize in visceral site rather than parietal pleura. We found only two reports of loculated transudates in peripheral lung regions .  Encapsulated transudative effusion was affected right upper region in one paper  and in our patient. The predilection of this area may be due to higher negativity in the intrapleural pressure or pleural adhesions caused by repeated thoracentesis. In conclusion, loculated transudate strongly suggests an unstable cardiac event, and it can present with atypical localization.

Anahtar Kelimeler

Pleural Effusion, Exudates and Transudates, Diagnosis

Loküle transuda

Öz

The association between heart failure and phantom tumor has been well known for years. Because drainage mechanism exists in parietal pleura, phantom tumors generally localize between fissures. Loculated transudate in peripheral lung areas is extremely rare. We present an interesting case of encapsulated transudative pleural effusion associated with pneumonia. The pleural fissures, formed by a double layer of visceral pleura, represent extensions of the pleural space between lobes of the lungs. Localized transudative effusion between fissures, known as phantom tumor or vanishing tumor, can be seen during fluid overload. Because most pleural fluid drainage occurs through parietal pleural lymphatics , effusions tend to localize in visceral site rather than parietal pleura. We found only two reports of loculated transudates in peripheral lung regions . Encapsulated transudative effusion was affected right upper region in one paper and in our patient. The predilection of this area may be due to higher negativity in the intrapleural pressure or pleural adhesions caused by repeated thoracentesis. In conclusion, loculated transudate strongly suggests an unstable cardiac event, and it can present with atypical localization.

Anahtar Kelimeler

Plevral efüzyon, transuda, eksuda, tanı

Kaynakça

• Referans 1 Kho SS, Tay PS, Lee J, Tie ST. Loculated transudative pleural effusion masquerading as right upper lobe consolidation in a haemodialysis patient. AME Case Rep. 2017;1:4.Referans 2 Miserocchi G. Mechanisms controlling the volume of pleural fluid and extravascular lung water. Eur Respir Rev 2009;18:244-52.Referans 3 Pereira W Jr, Kovnat DM, Snider GL. Subcostal loculated pleural effusion in congestive heart failure: an unusual case of vanishing tumor. Am J Med Sci. 1975;269:395-8.Referans 4 Banyai AL. Predilection of the right hemithorax for diseases. Chest 1969; 56: 23.