Synonyms
Pleural sarcoidosis; Pleural tuberculosis; Pleurisy
Definition
Granulomatous pleuritis is a descriptive term referring to granulomatous inflammation of the pleura. Causes of granulomatous pleuritis include infectious and noninfectious etiologies. Tuberculosis is the most common infectious cause. However, infection from nontuberculous mycobacteria, fungi, (e.g., Cryptococcus neoformans), parasites, and other bacteria (e.g., actinomyces) may also cause this pattern of injury. Causes of noninfectious granulomatous pleuritis include sarcoidosis, rheumatoid nodules in rheumatoid arthritis, and iatrogenic, causes among others.
Tuberculosis
Clinical Features
Incidence
Worldwide, tuberculous pleuritis is the most common etiology of granulomatous pleuritis. Pleural tuberculosis is the second most common type of extrapulmonary tuberculosis (after tuberculous lymphadenitis). It accounts for 4% of tuberculosis cases in the United States and greater than 10% of cases in Spain (Baumann et...
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References and Further Reading
Abrams, W. B., & Small, M. J. (1960). Current concepts of tuberculous pleurisy with effusion as derived from pleural biopsy studies. Diseases of the Chest, 38, 60–65.
Akcay, S., Pinelli, V., Marchetti, G. P., & Tassi, G. F. (2008). The diagnosis of sarcoidosis pleurisy by medical thoracoscopy: Report of three cases. Tüberküloz ve Toraks, 56(4), 429–433.
al-Qorain, A., Larbi, E. B., al-Muhanna, F., Satti, M. B., Baloush, A., & Falha, K. (1994). Pattern of pleural effusion in Eastern Province of Saudi Arabia: A prospective study. East African Medical Journal, 71(4), 246–249.
Antoniskis, D., Amin, K., & Barnes, P. F. (1990). Pleuritis as a manifestation of reactivation tuberculosis. American Journal of Medicine, 89(4), 447–450.
Arakawa, A., Nabeshima, M., Takahashi, M., Yasunaga, T., Nakashima, K., Okuda, T., et al. (1994). CT findings of pulmonary sarcoidosis. Nippon Rinsho, 52(6), 1521–1524.
Askin, F. B., McCann, B. G., & Kuhn, C. (1977). Reactive eosinophilic pleuritis. A lesion to be distinguished from pulmonary eosinophilic granuloma. Archives of Pathology and Laboratory Medicine, 101, 187–192.
Baba, K., Dyrhol-Riise, A. M., Sviland, L., Langeland, N., Hoosen, A. A., Wiker, H. G., et al. (2008). Rapid and specific diagnosis of tuberculous pleuritis with immunohistochemistry by detecting Mycobacterium tuberculosis complex specific antigen MPT64 in patients from a HIV endemic area. Applied Immunohistochemistry & Molecular Morphology, 16(6), 554–561.
Barbolini, G., Bisetti, A., Colizzi, V., Damiani, G., Migaldi, M., & Vismara, D. (1989). Immunohistologic analysis of mycobacterial antigens by monoclonal antibodies in tuberculosis and mycobacteriosis. Human Pathology, 20(11), 1078–1083.
Baumann, M. H., Nolan, R., Petrini, M., Lee, Y. C., Light, R. W., & Schneider, E. (2007). Pleural tuberculosis in the United States: Incidence and drug resistance. Chest, 131(4), 1125–1132.
Blackmon, G. M., & Raghu, G. (1995). Pulmonary sarcoidosis: A mimic of respiratory infection. Seminars in Respiratory Infections, 10(3), 176–186.
Bourkadi, J. E., Benjelloun, M. C., Amara, B., Bernoussi, Z., Lotfi, S., & Iraqi, G. H. (2000). Pleurisy and sarcoidosis. Apropos of 2 cases. Revue de Pneumologie Clinique, 56(5), 325–328.
Chakrabarti, B., & Davies, P. D. (2006). Pleural tuberculosis. Monaldi Archives for Chest Disease, 65(1), 26–33.
Chittock, D. R., Joseph, M. G., Paterson, N. A., & McFadden, R. G. (1994). Necrotizing sarcoid granulomatosis with pleural involvement. Clinical and radiographic features. Chest, 106(3), 672–676.
Closs, O., Harboe, M., Axelsen, N. H., Bunch-Christensen, K., & Magnusson, M. (1980). The antigens of Mycobacterium bovis, strain BCG, studied by crossed immunoelectrophoresis: A reference system. Scandinavian Journal of Immunology, 12(3), 249–263.
Cohen, M., & Sahn, S. A. (2001). Resolution of pleural effusions. Chest, 119(5), 1547–1562.
Diacon, A. H., Van de Wal, B. W., Wyser, C., Smedema, J. P., Bezuidenhout, J., Bolliger, C. T., et al. (2003). Diagnostic tools in tuberculous pleurisy: A direct comparative study. European Respiratory Journal, 22(4), 589–591.
Didilescu, C., Marica, M., & Jalba, M. (1992). The epidemiological aspects of tuberculous pleurisy in Romania. Pneumoftiziologia, 41(2–3), 83–87.
English, J. C., & Leslie, K. O. (2006). Pathology of the pleura. Clinics in Chest Medicine, 27(2), 157–180.
Epstein, D. M., Kline, L. R., Albelda, S. M., & Miller, W. T. (1987). Tuberculous pleural effusions. Chest, 91(1), 106–109.
Fijolek, J., Wiatr, E., Gawryluk, D., Langfort, R., & Bestry, I. (2010). Pleural sarcoidosis – A report of three cases. Pneumonologia i Alergologia Polska, 78(1), 79–82.
Gardiner, I. T., & Uff, J. S. (1978). Acute pleurisy in sarcoidosis. Thorax, 33(1), 124–127.
George, R. B., Penn, R. L., & Kinasewitz, G. T. (1985). Mycobacterial, fungal, actinomycotic, and nocardial infections of the pleura. Clinics in Chest Medicine, 6(1), 63–75.
Gopi, A., Madhavan, S. M., Sharma, S. K., & Sahn, S. A. (2007). Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest, 131(3), 880–889.
Harisinghani, M. G., McLoud, T. C., Shepard, J. A., Ko, J. P., Shroff, M. M., & Mueller, P. R. (2000). Tuberculosis from head to toe. Radiographics, 20(2), 449–470; quiz 528–449, 532.
Haro, M., Ruiz-Manzano, J., Gallego, M., Abad, J., Manterola, J. M., & Morera, J. (1996). Pleural tuberculosis: Analysis of 105 cases. Enfermedades Infecciosas y MicrobiologÃa ClÃnica, 14(5), 285–289.
Hasaneen, N. A., Zaki, M. E., Shalaby, H. M., & El-Morsi, A. S. (2003). Polymerase chain reaction of pleural biopsy is a rapid and sensitive method for the diagnosis of tuberculous pleural effusion. Chest, 124(6), 2105–2111.
Hashimoto, M., Watanabe, O., Sato, K., Endo, K., Heianna, J., Itoh, I., et al. (1996). The CT findings of pulmonary sarcoidosis. Tohoku Journal of Experimental Medicine, 179(4), 259–266.
Heidecker, J. T., & Judson, M. A. (2003). Pleural effusion caused by trapped lung. Southern Medical Journal, 96(5), 510–511.
Huggins, J. T., Doelken, P., Sahn, S. A., King, L., & Judson, M. A. (2006). Pleural effusions in a series of 181 outpatients with sarcoidosis. Chest, 129(6), 1599–1604.
Im, J. G., Whang, H. Y., Kim, W. S., Han, M. C., Shim, Y. S., & Cho, S. Y. (1992). Pleuropulmonary paragonimiasis: Radiologic findings in 71 patients. AJR. American Journal of Roentgenology, 159(1), 39–43.
Ishigami, A., Kubo, S., Tokunaga, I., Gotohda, T., & Nishimura, A. (2009). An autopsy case of severe pleuritis induced by misinsertion of a nasogastric nourishment tube: Diagnostic significance of multinucleated giant cells. Legal Medicine (Tokyo), 11(4), 191–194.
Ishikawa, S., Yano, S., Tokuda, Y., Kobayashi, K., Ikeda, T., & Takeyama, H. (2008). A case of Mycobacterium intracellulare pleurisy without active lung lesion. Kekkaku, 83(1), 27–31.
Izumikawa, K., Zhao, Y., Motoshima, K., Takazono, T., Saijo, T., Kurihara, S., et al. (2008). A case of pulmonary cryptococcosis followed by pleuritis in an apparently immunocompetent patient during fluconazole treatment. Medical Mycology, 46(6), 595–599.
Johnson, N. M., Martin, N. D., & McNicol, M. W. (1980). Sarcoidosis presenting with pleurisy and bilateral pleural effusions. Postgraduate Medical Journal, 56(654), 266–267.
Kakugawa, T., Mukae, H., Kajiki, S., Tanaka, A., Yamayoshi, T., Inoue, M., et al. (2008). Mycobacterium avium pleuritis in a non-immunocompromised patient. Internal Medicine, 47(19), 1727–1731.
Kim, H. J., Lee, H. J., Kwon, S. Y., Yoon, H. I., Chung, H. S., Lee, C. T., et al. (2006). The prevalence of pulmonary parenchymal tuberculosis in patients with tuberculous pleuritis. Chest, 129(5), 1253–1258.
Kirsch, C. M., Kroe, D. M., Azzi, R. L., Jensen, W. A., Kagawa, F. T., & Wehner, J. H. (1997). The optimal number of pleural biopsy specimens for a diagnosis of tuberculous pleurisy. Chest, 112(3), 702–706.
Kitamura, A., Matsuno, T., Narita, M., Shimokata, K., Yamashita, Y., & Mori, N. (2004). Rheumatoid arthritis with diffuse pulmonary rheumatoid nodules. Pathology International, 54(10), 798–802.
Kumar, S., Verma, S. K., Singh, R., & Prasad, R. (2009). Hemorrhagic pleural effusion secondary to sarcoidosis: A brief review. Annals of Thoracic Medicine, 4(1), 27–31.
Lee, K. S., & Im, J. G. (1995). CT in adults with tuberculosis of the chest: characteristic findings and role in management. AJR. American Journal of Roentgenology, 164(6), 1361–1367.
Lynch, J. P., 3, Kazerooni, E. A., & Gay, S. E. (1997). Pulmonary sarcoidosis. Clinics in Chest Medicine, 18(4), 755–785.
Ma, Y., Gal, A., & Koss, M. N. (2007). The pathology of pulmonary sarcoidosis: Update. Seminars in Diagnostic Pathology, 24(3), 150–161.
Miyaji, A., Konno, H., Yamazaki, M., & Ohwada, A. (2005). A patient with pleural thickening of sarcoidosis. Nihon Kokyūki Gakkai Zasshi, 43(5), 308–312.
Moore, D. A., Evans, C. A., Gilman, R. H., Caviedes, L., Coronel, J., Vivar, A., et al. (2006). Microscopic-observation drug-susceptibility assay for the diagnosis of TB. New England Journal of Medicine, 355(15), 1539–1550.
Moudgil, H., Sridhar, G., & Leitch, A. G. (1994). Reactivation disease: The commonest form of tuberculous pleural effusion in Edinburgh, 1980–1991. Respiratory Medicine, 88(4), 301–304.
Muller, N. L., Mawson, J. B., Mathieson, J. R., Abboud, R., Ostrow, D. N., & Champion, P. (1989). Sarcoidosis: Correlation of extent of disease at CT with clinical, functional, and radiographic findings. Radiology, 171(3), 613–618.
Nelson, O., & Light, R. W. (1977). Granulomatous pleuritis secondary to blastomycosis. Chest, 71(3), 433–434.
Nishimura, K., Itoh, H., Kitaichi, M., Nagai, S., & Izumi, T. (1993). Pulmonary sarcoidosis: Correlation of CT and histopathologic findings. Radiology, 189(1), 105–109.
Nishimura, K., Itoh, H., Kitaichi, M., Nagai, S., & Izumi, T. (1995). CT and pathological correlation of pulmonary sarcoidosis. Seminars in Ultrasound, CT and MR, 16(5), 361–370.
Patiala, J. (1954). Initial tuberculous pleuritis in the Finnish armed forces in 1939–1945 with special reference to eventual postpleuritic tuberculosis. Acta Tuberculosea Scandinavica. Supplementum, 36, 1–57.
Porcel, J. M. (2009). Tuberculous pleural effusion. Lung, 187(5), 263–270.
Rakower, J., & Milwidsky, H. (1964). Hydatid pleural disease. American Review of Respiratory Disease, 90, 623–631.
Roberts, P. P. (1988). Parasitic infections of the pleural space. Seminars in Respiratory Infections, 3(4), 362–382.
Seibert, A. F., Haynes, J., Jr., Middleton, R., & Bass, J. B., Jr. (1991). Tuberculous pleural effusion. Twenty-year experience. Chest, 99(4), 883–886.
Shu, C. C., Lee, L. N., Wang, J. T., Chien, Y. J., Wang, J. Y., & Yu, C. J. (2010). Non-tuberculous mycobacterial pleurisy: An 8-year single-centre experience in Taiwan. The International Journal of Tuberculosis and Lung Disease, 14(5), 635–641, 634 p following 641.
Solomon, A., Kreel, L., McNicol, M., & Johnson, N. (1979). Computed tomography in pulmonary sarcoidosis. Journal of Computer Assisted Tomography, 3(6), 754–758.
Soskel, N. T., & Sharma, O. P. (2000). Pleural involvement in sarcoidosis. Current Opinion in Pulmonary Medicine, 6(5), 455–468.
Sun, Y. C., Yao, W. Z., Shen, N., Shi, X. Y., & Zhao, M. W. (2006). Pleural sarcoidosis: Report of cases and review of the literature. Zhonghua Jie He He Hu Xi Za Zhi, 29(4), 243–246.
Szwarcberg, J. B., Glajchen, N., & Teirstein, A. S. (2005). Pleural involvement in chronic sarcoidosis detected by thoracic CT scanning. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, 22(1), 58–62.
Takagi, N., Hasegawa, Y., Ichiyama, S., Shibagaki, T., & Shimokata, K. (1998). Polymerase chain reaction of pleural biopsy specimens for rapid diagnosis of tuberculous pleuritis. The International Journal of Tuberculosis and Lung Disease, 2(4), 338–341.
Tang, S. J., Xiao, H. P., Chen, G., Liu, Y. D., Fan, L., Zhang, Q., et al. (2009). Clinical, pathological and radiological characteristics of 83 cases of pleural tuberculoma. Zhonghua Jie He He Hu Xi Za Zhi, 32(4), 262–265.
Tovar, M., Siedner, M. J., Gilman, R. H., Santillan, C., Caviedes, L., Valencia, T., et al. (2008). Improved diagnosis of pleural tuberculosis using the microscopic- observation drug-susceptibility technique. Clinical Infectious Diseases, 46(6), 909–912.
Trajman, A., Pai, M., Dheda, K., van Zyl Smit, R., Zwerling, A. A., Joshi, R., et al. (2008). Novel tests for diagnosing tuberculous pleural effusion: What works and what does not? European Respiratory Journal, 31(5), 1098–1106.
Triebel, H. J., Kanzow, G., Heller, M., Magnussen, H., & Bucheler, E. (1990). The importance of thoracic CT in the diagnosis of pulmonary sarcoidosis. Rofo, 153(5), 557–564.
Tserkezoglou, A., Metakidis, S., Papastamatiou-Tsimara, H., & Zoitopoulos, M. (1978). Solitary rheumatoid nodule of the pleura and rheumatoid pleural effusion. Thorax, 33(6), 769–772.
Ulrichs, T., Lefmann, M., Reich, M., Morawietz, L., Roth, A., Brinkmann, V., et al. (2005). Modified immunohistological staining allows detection of Ziehl-Neelsen-negative Mycobacterium tuberculosis organisms and their precise localization in human tissue. Journal of Pathology, 205(5), 633–640.
Valdes, L., Alvarez, D., Valle, J. M., Pose, A., & San Jose, E. (1996). The etiology of pleural effusions in an area with high incidence of tuberculosis. Chest, 109(1), 158–162.
Valdes, L., Alvarez, D., San Jose, E., Penela, P., Valle, J. M., Garcia-Pazos, J. M., et al. (1998). Tuberculous pleurisy: A study of 254 patients. Archives of Internal Medicine, 158(18), 2017–2021.
Villegas, M. V., Labrada, L. A., & Saravia, N. G. (2000). Evaluation of polymerase chain reaction, adenosine deaminase, and interferon-gamma in pleural fluid for the differential diagnosis of pleural tuberculosis. Chest, 118(5), 1355–1364.
Wada, R., Itabashi, C., Nakayama, Y., Ono, Y., Murakami, C., & Yagihashi, S. (2003). Chronic granulomatous pleuritis caused by nocardia: PCR based diagnosis by nocardial 16S rDNA in pathological specimens. Journal of Clinical Pathology, 56(12), 966–969.
Watarai, M., Yazawa, M., Yamanda, K., Yamamoto, H., & Yamazaki, Y. (2002). Pulmonary sarcoidosis with associated bloody pleurisy. Internal Medicine, 41(11), 1021–1023.
Wilen, S. B., Rabinowitz, J. G., Ulreich, S., & Lyons, H. A. (1974). Pleural involvement in sarcoidosis. American Journal of Medicine, 57(2), 200–209.
Xanthakis, D. S., Katsaras, E., Efthimiadis, M., Papadakis, G., Varouchakis, G., & Aligizakis, C. (1981). Hydatid cyst of the liver with intrathoracic rupture. Thorax, 36(7), 497–501.
Yilmaz, M. U., Kumcuoglu, Z., Utkaner, G., Yalniz, O., & Erkmen, G. (1998). Computed tomography findings of tuberculous pleurisy. The International Journal of Tuberculosis and Lung Disease, 2(2), 164–167.
Young, E. J., Hirsh, D. D., Fainstein, V., & Williams, T. W. (1980). Pleural effusions due to Cryptococcus neoformans: A review of the literature and report of two cases with cryptococcal antigen determinations. American Review of Respiratory Disease, 121(4), 743–747.
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Guinee, D. (2018). Granulomatous Pleuritis. In: Allen, T.C., Suster, S. (eds) Pathology of the Pleura and Mediastinum. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-66796-6_362
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