CLINICAL AND ANATOMICAL CHARACTERISTIC OF THE PLEURAL CAVITY IN PLEURAL EMPYEMA

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Aim. To identify the clinical and anatomic features of the pleural cavity in pleural empyema. Material and Methods. A post mortem examination of 27 patients with diagnosed pleural empyema was performed. In compliance with the clinical and morphological classification, 170 pleural adhesions of different types were identified. Morphological evaluation by hematoxylin and eosin was performed, in addition to van Gieson’s staining. Results and Discussion. Of 27 pleural empyema patients, 11 (40.7%) showed the residual pleural cavities of various sizes and of these, purulent detritus with no inflammation and obliteration was present in 7 (25.9%) cases. The multiple pleural adhesions were found in 16 cases (9.4%). Of 170 adhesions, 83 (48.8%), 51 (30.0%), 25 (14.7%), and (6.5%) were planar, membranous, cordlike, and combined, respectively. Microscopically, the isolated adhesions showed the mature fibrous tissue which mainly included collagen and elastic fibers. The formed adhesions were richly vascularized and characterized by lymphoplasmacytic infiltration with single macrophages and leukocytes. The microscopic findings evidence the chronic inflammation in the formed adhesions. Conclusions. 1. Chronic pleural empyema is often becomes complicated by the formation of adhesions, however, in 40.7% cases the adhesion forma tion was not active and as a result the residual pleural cavities were formed. 2. It is reasonable to stimulate adhesion formation to obliterate the residual cavities with the connective tissue.