胸膜疾患：種類と簡単な説明

The pleura is a double-layered membrane surrounding the lungs. The visceral pleura covers the lungs, while the parietal pleura lines the chest cavity. Between these layers lies the pleural cavity, which contains pleural fluid that lubricates and cushions the lungs during breathing, enabling smooth movement during inhalation and exhalation.

Pleurisy, or pleuritis, is inflammation of the pleura caused by pneumonia, autoimmune diseases, infections, or chest injuries. It produces sharp chest pain that worsens during breathing, coughing, or sneezing, along with difficulty breathing. The pleuritic pain is the hallmark symptom distinguishing this condition from other pleural disorders.

Pneumothorax occurs when air enters the pleural cavity, causing partial or complete lung collapse. It results from chest trauma, underlying lung disease, or spontaneous rupture. Patients experience sudden chest pain and shortness of breath. Diagnosis typically involves chest X-rays or CT scans to confirm air presence in the pleural space.

Hemothorax is the accumulation of blood in the pleural cavity, typically from chest trauma, surgery, or blood vessel rupture. Unlike pneumothorax, which involves air, hemothorax presents with hypotension, chest pain, and dyspnea. It can lead to lung collapse and respiratory distress, requiring urgent intervention to restore respiratory function.

Empyema is the collection of pus in the pleural cavity resulting from bacterial infections, commonly following pneumonia, lung abscesses, or chest surgery. Symptoms include fever, chest pain, and breathing difficulties. This serious condition requires prompt diagnosis through imaging and may necessitate thoracentesis, a procedure that drains fluid from the pleural space.

Pleural effusion involves excess fluid accumulation in the pleural cavity due to congestive heart failure, pneumonia, liver disease, or cancer. Patients experience cough and dyspnea. Management of pleural effusion symptoms and management depends on the underlying cause and severity, often involving imaging studies and therapeutic drainage procedures.

Mesothelioma is a rare, aggressive cancer targeting the mesothelium, the thin tissue layer enveloping internal organs. Pleural mesothelioma, the most common variant, manifests in the visceral pleura that encases the lungs. This serious malignancy requires specialized diagnostic imaging and treatment planning to manage its progression and respiratory complications.