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Pleural effusion caused by trapped lung.

Jay T Heidecker1, Marc A Judson

  • 1Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.

Southern Medical Journal
|August 13, 2003
PubMed
Summary
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Sarcoidosis can cause trapped lung, leading to pleural effusion. Decortication relieved symptoms when corticosteroids failed, confirming noncaseating granulomas in lung and pleural tissues.

Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Rheumatology

Background:

  • Sarcoidosis is a multisystem inflammatory disease characterized by noncaseating granulomas.
  • Pleural effusion is an uncommon manifestation of sarcoidosis.
  • Trapped lung can occur due to inflammatory processes encasing the lung parenchyma.

Observation:

  • A patient presented with dyspnea, right pleural effusion, mediastinal widening, and bilateral upper-lobe infiltrates.
  • Initial treatment with oral corticosteroids did not resolve the pleural effusion or dyspnea.
  • Surgical intervention (decortication) with stripping of inflammatory fibrous bands led to symptom relief.

Findings:

  • Histological examination confirmed noncaseating granulomas in the lung, visceral pleura, parietal pleura, and fibrous adhesions.

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  • The findings indicate a direct link between sarcoidosis-related inflammation and the development of trapped lung with pleural effusion.

    • Implications:

    • This case highlights trapped lung as a potential complication of sarcoidosis, even with typical respiratory findings.
    • Decortication may be an effective treatment option for refractory pleural effusion and dyspnea in sarcoidosis-induced trapped lung.
    • Further research is warranted to understand the pathogenesis and optimal management of pleural involvement in sarcoidosis.