Fibrothorax is defined as fibrosis within the pleural space (usually when encompassing and restricting) and is sometimes referred to as pleural peel. It occurs secondary to an inflammatory response to one of the following events:
- tuberculosis / tuberculous pleuritis / tuberculous empyema: mainly as a late sequela 3
- thoracic empyema
- asbestos-related pleural disease
- rheumatoid arthritis
- connective tissue disease
- drug reactions
- therapeutic pleurodesis
Fibrothorax is characterized by relatively smooth pleural thickening (hence peel) that may be calcified. The mediastinal pleura is usually spared, and commonly there is marked volume loss of the affected hemithorax.
Treatment and prognosis
Treatment options can range from conservative to surgical intervention with pleural decortication considered in selected cases 5.
- 1. O'Brien W, Sr. WT. Top 3 Differentials in Radiology, A Case Review. Thieme Medical Pub. (2009) ISBN:1604062266. Read it at Google Books - Find it at Amazon
- 2. Lange S, Walsh G, (FRCR.) GW. Radiology of Chest Diseases. George Thieme Verlag. (2007) ISBN:1588904474. Read it at Google Books - Find it at Amazon
- 3. Choi JA, Hong KT, Oh YW et-al. CT manifestations of late sequelae in patients with tuberculous pleuritis. AJR Am J Roentgenol. 2001;176 (2): 441-5. AJR Am J Roentgenol (full text) - Pubmed citation
- 4. Müller NL. Imaging of the pleura. Radiology. 1993;186 (2): 297-309. Radiology (citation) - Pubmed citation
- 5. Alhassan S, Fasanya A, Thirumala R. Extensive Calcified Fibrothorax. (2017) American journal of respiratory and critical care medicine. 195 (4): e25-e26. doi:10.1164/rccm.201606-1265IM - Pubmed