title: Acute nonbacterial pleuritis caused by spontaneous rupture of metastatic pulmonary adenocarcinoma.
abstract: Nonbacterial pleuritis caused by rupture of a metastatic adenocarcinoma is extremely rare and has not yet been reported. A 59-year-old man with a history of rectal cancer surgery 6 years earlier presented with a solitary lung mass in the periphery of the right lower lobe on computed tomography. Transbronchial biopsy disclosed a suspected metastatic adenocarcinoma, and he was admitted for pulmonary metastasectomy. He had been asymptomatic, but 4 weeks after the diagnostic bronchoscopy, the patient suddenly complained of a right back pain and dyspnea at rest; shortly after that, he developed a fever of 39 degrees C. A chest X-ray showed right pleural effusion, collapse of the right lower lobe, and elevation of the right diaphragmatic dome, but without pneumothorax. Emergent video-assisted thoracoscopy revealed a perforated tumor in the collapsed lower lobe, and a right lower lobectomy was carried out. The postoperative course was uneventful, and he was well without recurrent disease 2 years after pulmonary resection.
authors.affiliation: Department of Thoracic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan. taiwata@med.osaka-cu.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwata
authors.forename: Kiyotoshi
authors.initials: K
authors.lastname: Inoue
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Morita
authors.forename: Takuma
authors.initials: T
authors.lastname: Tsukioka
authors.forename: Masaya
authors.initials: M
authors.lastname: Yamoto
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Suehiro
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000150:complications* / Q000556:secondary / Q000601:surgery; D001999:Bronchoscopy; D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology; D010998:Pleurisy / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011013:Pneumonectomy; D001261:Pulmonary Atelectasis / Q000209:etiology; D013902:Radiography, Thoracic; D012422:Rupture, Spontaneous; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome