Extrapleural pneumonectomy is indicated in some cases of malignant mesothelioma and tuberculous empyema and involves resection of lung and parietal pleura
with prosthetic reconstruction.
Gas can enter the pleural space through an opening in the visceral pleura from inside the lungs, or through a communication between the pleural space and the atmosphere through the chest wall and parietal pleura
There was one patient in our study with primary pleural hydatid, In this patient, many cystic structures were drained, and complete decortication of the parietal pleura
These cysts were ribbon like and arranged along the mediastinal and parietal pleura
, and could be the source of spontaneous pneumothorax in our case.
The apex of the lung is usually retained within the thorax by the muscles of the thoracic inlet, Sibson fascia, and the parietal pleura
. Sibson fascia is also known as the deep cervical fascia, or suprapleural fascia, and acts like a diaphragm across the thoracic inlet, allowing the lung apex to rise above the first costosternal junction.
Neither cytological examination nor needle biopsy of the parietal pleura
was able to establish the diagnosis.
Biopsies were performed under direct vision in all suspicious areas (Figure 1) and systematically in several parts of the parietal pleura
for cytological and pathological examinations (Figure 2).
Malignant cells were seen in pleural effusion in 6 patients and pleural biopsy showed malignant infiltration of parietal pleura
in rest of 3 cases.
A cyst was found adherent to the parietal pleura
which was not communicating with the oesophagus.
In rabbit models, talc has been shown to be absorbed through the parietal pleura
into mediastinal lymph nodes and the thoracic duct, eventually entering the systemic lymphatic circulation .
This creates an inflammatory response along the visceral and parietal pleura
, causing the lung to adhere to the chest wall.
A sparganum larva was seen migrating along the parietal pleura