Using a unique case-based approach Pleural Diseases: Clinical Cases and Real-World Discussions brings you up to date with the latest advances in this fast-moving subspecialty. A wide variety of real-world challenges are presented along with multiple perspectives from expert pulmonologists who discuss and analyze each case collaboratively replicating actual patient experiences and outcomes. This first-of-its-kind resource is ideal for practicing pulmonologists and fellows interventional pulmonologists critical care physicians and others who are interested in an interactive approach to everyday clinical problems related to pleural disease.

Provides a unique, interactive approach to understanding the nuances and complexities of patient cases for both invasive and non-invasive therapies, drawing from real clinical cases and accompanying case discussions.
Describes the approach taken by experts for each case, presenting the clinical reasoning on the most appropriate approaches and the possible therapies.
Offers easy-to-read, templated information for every case: onset of symptoms, the entire diagnostic-therapeutic path including clinical and laboratory findings, and discussions on the clinical choices made in accordance with evidence-based medical procedures.
Includes both positive and negative outcomes for a broader experience.
Features more than 200 illustrations including x-rays, procedural photos, ultrasound, CT scans, and histopathology specimens, as well as video procedures for thoracentesis, chest tube placing, medical thoracoscopy, and insertion of indwelling pleural catheter.
Addresses other common clinical issues such as the management of multimorbid elderly patients, the optimization of fluid balance, and the need to discontinue antiplatelet or anticoagulant therapy before invasive procedures.
Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Author Information

Edited by Claudio Sorino, MD, PhD, Professor of Medicine and Associate Medical Director, Respiratory Pathophysiology Unit, Department of Pulmonary and Critical Care Medicine, Sant'Anna Hospital, Como, Italy ; David Feller-Kopman, MD, Professor of Medicine, Director, Bronchoscopy and Interventional Pulmonology, Johns Hopkins University Hospital, Baltimore, Maryland USA and Giampietro Marchetti, MD, Associate Medical Director of Interventional Pulmonology, Department of Pulmonology, Spedali Civili, Brescia, Italy


Part I. Malignancies

1. Malignant pleural effusion with unexpandable lung and hydropneumothorax following thoracentesis (Sorino, Feller-Kopman, Marchetti)

Management of malignant pleural effusion
Causes of pneumothorax after thoracentesis
The unexpandable lung
2. Pleural plaques, pleural effusion, and malignant pleural mesothelioma in a subject with previous asbestos exposure (Marchetti, Sorino, Feller-Kopman)

Histological and molecular diagnosis of malignant pleural mesothelioma
Imaging techniques in the diagnosis of mesothelioma
Management of malignant pleural mesothelioma
3. Malignant pleural effusion in metastatic pulmonary adenocarcinoma complicated by pulmonary embolism (Sorino, Feller-Kopman, Marchetti)

Molecular testing of advanced Non-Small Cell Lung Cancer (NSCLC)
Management of anticoagulant and antiplatelet therapy in adults undergoing percutaneous interventions
Venous thromboembolism: early diagnostic and therapeutic approach
4. Squamous cell lung cancer complicating a tuberculous fibrothorax (Marchetti, Sorino, Feller-Kopman)

Late sequelae and complications of tuberculosis
Malignancy associated with chronic empyema and fibrothorax
How to distinguish pleural from peripheral pulmonary lesions
5. Malignant pleural mesothelioma with trapped lung (Sorino, Lococo, Marchetti)

Medical thoracoscopy
Assessment of performance status
Pleurodesis
6. Lung adenocarcinoma with diffuse pleural infiltration (Gonuguntla, Sorino)

Rigid and semi-rigid thoracoscopy
Macroscopic appearance of pleural malignancy
Indications and types of pleurodesis
7. Chylothorax associated with an indolent follicular lymphoma (Lococo, Sorino, Marchetti)

Diagnosis of chylothorax and etiology
Treatment of chylothorax
Chest tube types and sizes
Part II. Infections

8. Relapsing unilateral pleural effusion revealed to be due to tuberculosis (Sorino, Feller-Kopman, Marchetti)

Chest ultrasound and pleural diseases
Indications of diagnostic thoracentesis
Tuberculous pleural effusion
9. Loculated parapneumonic pleural effusion treated with intra-cavitary urokinase (Zanforlin, Sorino, Marchetti, Feller-Kopman)

Chemical-physical examination of the pleural fluid
Indications for the insertion of a thoracic drainage tube
Role of fibrinolytics in complicated pleural effusions
10. Pleural empyema and sepsis in a patient with acute renal failure due to necrotizing extracapillary glomerulonephritis (Sorino, Pirracchio, Gildea)

Patient preparation before chest tube placement
Anti-glomerular basement membrane (anti-GBM) antibody disease
Acute-phase reactants and markers of bacterial infections
11. Pleural empyema with bronchopleural fistula and hydropneumothorax (Marchetti, Sorino)

Pleural empyema on ultrasound
Choice of the chest drain insertion site
Risk factors for pleural empyema
12. Pneumonia complicating chronic fibrothorax with persistent effusion in a multimorbid patient (Elia, Sorino, Marchetti)

Causes and mechanism of fibrothorax
Imaging of fibrothorax
Decortication
13. Bronchopleural fistula and pleural empyema after pneumonectomy (Minervini, Bertoglio, Sorino)

Strategies to prevent post-pneumonectomy empyema
Management of post pneumonectomy empyema
Minimally invasive surgery for post pneumonectomy empyema
14. Nontuberculous mycobacteria pleural infection in an immunosuppressed patient (Sorino, Gonuguntla, Gildea, Negri)

Nontuberculous mycobacteria infections in immunosuppressed hosts
Pleural empyema
Chest tube drainage
Part III. Miscellanea

15. Cloudy pleural effusion in a heavy smoker with rheumatoid arthritis undergoing immunosuppressive treatment (Mondoni, Carlucci, Sorino, Marchetti, Feller-Kopman)

Pseudochylothorax
Pleural fluid pH measurement
Moderate sedation in medical thoracoscopy
16. Bilateral calcified fibrothorax in a COPD patient (Sorino)

Consequences of asbestos inhalation
Pleural plaques
Mixed restrictive-obstructive patterns
17. Middle and low back pain due to pulmonary embolism with ipsilateral pleural effusion (Sorino, Marchetti, Gildea)

Well's criteria for pulmonary embolism - Three Tier Model
Pulmonary hemorrhage and lung infarction after pulmonary embolism
Pleural effusion in pulmonary embolism
18. Bilateral asymmetric pleural effusion due to congestive heart failure (Sorino, Gildea)

Pleural effusions from cardiovascular diseases congestive heart failure
Indwelling pleural catheters
IPCs in non-malignant disease
19. Hemothorax and tension pneumothorax following a crush injury with rib fractures (Sorino, Gildea)

Insertion of chest drains
Chest drainage systems
Management of chest drains
20. Pneumothorax after transthoracic needle biopsy (Sorino, Sampietro, Calati)

Transthoracic needle biopsy