The Intrapleural Bridge Connection is One of the Reasons for Unknown Localized Pleural Adhesion

Qihua Gu,1,2 Xinhao Deng,1,2 Zhao Li,1,2 Jing Wang,3 Chengping Hu,1,2 Shuhua Lei,1,2 Xiaoling Cai1,2 1Department of Respiratory Medicine, Xiangya Hospital Affiliated to Central South University, Changsha, Hunan Province, 410008, People’s Republic of China; 2Key Cite of National Clinical Research Center for Respiratory Disease, Changsha, Hunan Province, 410008, People’s Republic of China; 3Department of Pathology, Xiangya Hospital Affiliated to Central South University, Changsha, Hunan Province, 410008, People’s Republic of ChinaCorrespondence: Qihua Gu Tel +86 15973196025Email guqh06@163.comBackground: Simple signs of local pleural adhesion are often found in people during a physical examination. In the present study, we aimed to clarify whether the merely localized pleural adhesion was just caused by previous pleural inflammation or physiological variation.Materials and Methods: Chest X-ray image materials were collected to analyze the incidence of simple pleural adhesions. Moreover, the causes of these simple pleural adhesions were further analyzed using thoracoscopy under direct vision and biopsy data.Results: In all 2218 chest X-ray images, 68 cases were found to have pleural lesions (3.07%), including 15 cases of localized pleural adhesion only. Subsequently, we analyzed the characteristics of 70 cases of pleural lesions using thoracoscopy. In two lung cancer patients with pleural metastasis, we found an unusual pleural junction. This connective strip was smooth and free of inflammation, resembling the normal pleura.Conclusion: Some of these purely localized pleural adhesions might be attributed to previous inflammation. However, there was still at least a possibility that there must be a physiological pleural junction, which could be the cause of the purely localized pleural adhesion shown in the chest radiograph.Keywords: pleural adhesion, bridge connection, physiological variation, image, thoracoscope