Fibrosis can affect one or both of the two layers of tissue forming the pleura—the visceral pleura adjacent to the lung and the parietal pleura adjacent to the ribcage. The term<unk>  implies severe fibrosis affecting both the visceral and the outer (parietal) pleura, fusing the lung to the chest wall. The condition starts as an undrained pleural effusion. Over time, the undrained pleural effusion causes sustained inflammation of the pleura, which can then lead to deposition of fibrin in the pleura and the development of a fibrotic scar. Eventually, a "peel" that is rich in collagen forms around the fluid collection. From this point, the illness can no longer be treated with thoracentesis, since the fluid will return to the cavity maintained by the peel. Over time, generally over the years, the fibrotic scar tissue slowly tightens and thickens, contracting the contents of one or both halves of the chest and reducing the mobility of the ribs. The peel can become deeper than 2 cm. Within the chest, the lung is compressed and unable to expand (trapped lung), making it vulnerable to collapse and causing breathlessness. Restrictive lung disease from<unk>  may occur when pleural fibrosis is so severe that it involves the diaphragm and ribcage and results primarily from decreased rib movement. Microscopic At the microscopic level, collagen fibres deposit in a basket weave pattern and form scar tissue. Usually, the underlying condition has to cause intense inflammation of the pleura, though it is unclear exactly how this results in fibrosis. The precise mechanisms producing the fibrosis are not entirely clear. However, research indicates a protein called Transforming Growth Factor beta (TGF-β) plays a central role in producing<unk> . Anti-TGF-β antibodies prevent<unk>  in empyema in animal models.
Fibrothorax
Hydrothorax
Urinothorax
Pleurisy
Chylothorax
Hemothorax
Pleural empyema
Pneumothorax