Lung folding simulating peripheral pulmonary neoplasm (Blesovsky's syndrome)

Area of Science:

• Pulmonology
• Thoracic Surgery
• Radiology

Background:

• Benign pleural thickening can present radiographically, mimicking peripheral pulmonary neoplasms.
• Diagnosis is crucial to avoid unnecessary surgical intervention for non-malignant conditions.

Observation:

• Six cases of benign pleural thickening with lung folding were analyzed.
• Radiographs showed peripheral opacities and curvilinear shadows, suggestive of lung masses.
• Thoracotomy revealed thickened visceral pleura causing lung folding, with hyaline plaques on parietal pleura.

Findings:

• Five patients underwent successful visceral pleural removal, leading to lung re-expansion and normal radiographs.
• One patient with unaddressed lung folding continued to experience chest pain.
• Radiographic findings, particularly lateral tomography, are diagnostic for this condition.

Implications:

• Radiographic recognition can prevent unnecessary surgery in asymptomatic patients.
• Thoracotomy with pleural release is an effective treatment for symptomatic patients.
• Accurate diagnosis of benign pleural thickening is essential for appropriate patient management.