Rounded atelectasis due to acute exudative effusion. Spontaneous resolution

Our plain-English summary of Rounded atelectasis due to acute exudative effusion. Spontaneous resolution, by L.S. Smith, R.F. Schillaci (Chest, 1984).

The study

• Authors: L.S. Smith, R.F. Schillaci
• Journal: Chest
• Published: 1984;85(6):830-2
• Type of article: Case report
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Rounded atelectasis is an interesting roentgenographic entity that must be distinguished from intrathoracic neoplasm. Chronic pleural disease, particularly that due to asbestos exposure, is a frequently cited cause, and is considered to be a sine qua non by some. We report a case of rounded atelectasis with an acute parapneumonic exudative effusion that resolved spontaneously with roentgenographically normal pleura.

In plain English

This article was a case report of one patient with rounded atelectasis. This is a form of collapsed lung at the edge of the lung that can be confused with a lung tumor on X-ray. The authors noted that it is often linked to chronic pleural disease, particularly disease due to asbestos exposure. Their patient, a 59-year-old man, was hospitalized with fever, cough, chest pain and a right lower lobe infiltrate, and was treated for presumed pneumococcal pneumonia. Three days later a large right pleural effusion developed, and the fluid was a noninfected exudate. One month later a chest X-ray showed an oval 5 x 7-cm mass in the right lower lung field next to the pleura. X-ray and CT findings were thought to show rounded atelectasis. Three months later it had resolved completely, with no X-ray evidence of pleural thickening. The article does not say whether this patient had asbestos exposure. The authors concluded that exudative pleural effusions should also be considered as a cause, alongside asbestos-related chronic pleural disease. They added that spontaneous resolution is more likely when the cause is an acute effusion.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 59-year-old man, a 60 pack-year smoker, hospitalized with fever, chills, cough, pleuritic chest pain and a right lower lobe infiltrate. The authors were at the Naval Hospital, San Diego, California.
• Exposure: The article does not report whether the patient had any asbestos exposure. The rounded atelectasis was attributed to a large parapneumonic (pneumonia-related) exudative pleural effusion.
• Main results:
  • Three days after admission, the patient developed a large right pleural effusion. Thoracocentesis yielded an exudate with normal pH and negative Gram stains and cultures. At a repeat procedure, 600 ml of noninfected exudate was removed.
  • A follow-up chest X-ray one month later showed an oval 5 x 7-cm mass in the right lower lung field. On the lateral view it was posterior and pleural based.
  • Bronchoscopy showed mucosal edema but no endobronchial mass. The chest X-ray and CT findings were thought to demonstrate rounded atelectasis.
  • Three months later, a chest film showed complete resolution of the rounded atelectasis, with no radiologic evidence of pleural thickening.
• The authors' conclusion: The authors concluded that current literature emphasizes chronic pleural disease associated with asbestos exposure as the predominant cause of rounded atelectasis, but that exudative pleural effusions should also be considered. They also stated that spontaneous resolution is more likely if the cause is an acute exudative effusion, as the fibrinous attachments resolve.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Rounded Atelectasis, Intrathoracic, Neoplasm, Asbestos Exposure, Pleura.

Related studies

• Rounded atelectasis and mesothelioma — R.F. Munden, H.I. Libshitz (1998)
• An unusual case of rounded atelectasis — G. Geremia, R.A. Mintzer (1984)
• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)
• Rounded atelectasis of the lung — G.T. Stathopoulos, M.T. Karamessini, et al. (2005)
• Asbestos-related rounded atelectasis. Radiologic and mineralogic data in 23 cases — C. Voisin, F. Fisekci, et al. (1995)
• Rounded atelectasis associated with pulmonary lymphangioleiomyomatosis — K. Kishi, S. Homma, et al. (2005)

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