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Pleural Adhesions

Etiology: • Usually the sequel to inflammatory or fibrinous pleuritis • May also be associated with underlying pulmonary fibrosing disease • Asbestos may caused localized pleural fibrosis

Pathogenesis: • In response to organisms or other stimulus pleural edema develops • Fibrinous exudate forms • Organization of the exudate by vessel ingrowth and fibroblast proliferation results in adhesions

Epidemiology: • Dependent on the epidemiology of the underlying pulmonary disease

General Gross Description: • Fibrous adhesions are gray, membranous and dull • May be quite dense and difficult to dissect

General Microscopic Description: • Composed of fibroblasts and collagen

Clinical Correlations: • Usually incidental finding at autopsy • Massive adhesions may lead to restriction of pulmonary expansion with symptoms of restrictive pulmonary disease.

References: • Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders; Philadelphia, pp. 728-730 • Saldana MJ, Pathology of Pulmonary Disease, J.B. Lippincott; Philadelphia. pp. 868-9.