Shrinking pleuritis with lobar atelectasis, a morphologic variant of “round atelectasis”

• Published in: Human pathology Vol. 20; no. 4; pp. 382 - 387
• Main Authors: Chung-Park, Moonja, Tomashefski, Joseph F., Cohen, Alan M., El-Gazzar, Mourad, Cotes, Enrique E.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1989; Elsevier
• Subjects: Aged; Aged, 80 and over; atelectasis; Biological and medical sciences; Coal Mining; Female; Fibrosis; Humans; Lung - pathology; Male; Medical sciences; Middle Aged; Pleura - pathology; pleural effusion; Pleural Effusion - complications; pleuritis; Pneumology; Pulmonary Atelectasis - diagnostic imaging; Pulmonary Atelectasis - etiology; Pulmonary Atelectasis - pathology; Radiography, Thoracic; Respiratory system : syndromes and miscellaneous diseases; pleuritis; pleural effusion; atelectasis; Pulmonary lobe; Pathology; Atelectasis; Respiratory disease; Autopsy; Lung
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/0046-8177(89)90048-8

Round atelectasis (shrinking pleuritis) is typically a localized process characterized by focal pleural scarring and subjacent peripheral atelectasis. We report three patients, studied at autopsy, with an unusual variant of round atelectasis, termed shrinking pleuritis with lobar atelectasis, which is characterized by lobar atelectasis, visceral pleural fibrosis involving multiple lobes, interlobar fibrous cords, pleural effusion, and nonspecific, persistent infiltrates on chest radiogram. The possible causes of shrinking pleuritis with lobar atelectasis in our patients were multiple and included environmental dust exposure, infection, uremia, and recurrent pleural effusions. Our findings support both the folding (pleural effusion) and fibrosing (pleural injury) theories of pathogenesis of round atelectasis and emphasize the spectrum of morphologic variability in this condition.