Idiopathic lymphocytic pleuritis: radiographic and high-resolution CT appearances and changes in response to therapy in two adults

Published:December 03, 2009DOI:


      Inflammatory conditions of the pleura characterized by a predominantly lymphocytic infiltrate are described in several disorders. The commonest underlying aetiologies include tuberculous infection, autoimmune disorders (particularly Sjogren's syndrome), and post coronary artery bypass graft surgery. Idiopathic lymphocytic pleuritis (ILP) is a rare form of diffuse pleural inflammation characterized by extensive lymphocytic infiltration for which no cause is found. Radiological descriptions of ILP are limited. We describe the radiographic and high-resolution computed tomography (HRCT) imaging features and response to corticosteroid therapy of ILP in two adults. Both patients presented with bilateral diffuse pleural thickening of >10 mm thickness extending >10 cm craniocaudally with small focal areas of atelectasis. Both cases demonstrated marked improvement in the degree and extent of pleural thickening and rounded atelectasis following corticosteroid therapy. HRCT provided a useful noninvasive method of assessing disease response to therapy.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • English JC
        • Leslie KO
        Pathology of the pleura.
        Clin Chest Med. 2006; 27: 157-180
        • Muller NL
        Imaging of the pleura.
        Radiology. 1993; 186: 297-309
        • Villena Garrido V
        • Ferrer Sancho J
        • Hernandez Blasco L
        • de Pablo Gafas A
        • Perez Rodriguez E
        • Rodriguez Panadero F
        • et al.
        Diagnosis and treatment of pleural effusion.
        Arch Bronconeumol. 2006; 42: 349-372
        • O'Connor TM
        • Haider W
        • Crotty T
        • McDonnell TJ
        • McNicholas WT
        Immunosuppressant-responsive idiopathic lymphocytic pleuritis.
        Respiration. 2005; 72: 202-204
        • Fraser RS
        • Colman N
        • Muller NL
        • Pare PD
        Synopsis of diseases of the chest.
        3rd ed. Elsevier/Saunders, Philadelphia2005
        • Kuhlman JE
        Complex disease of the pleural space: the 10 questions most frequently asked of the radiologist—new approaches to their answers with CT and MR imaging.
        Radiographics. 1997; 17: 1043-1050
        • Middleton KL
        • Santella R
        • Couser JI
        Eosinophilic pleuritis due to propylthiouracil.
        Chest. 1993; 103: 955-956
        • Leung AN
        • Muller NL
        • Miller RR
        CT in differential diagnosis of diffuse pleural disease.
        AJR Am J Roentgenol. 1990; 154: 487-492
        • Buchanan DR
        • Johnston ID
        • Kerr IH
        • Hetzel MR
        • Corrin B
        • Turner-Warwick M
        Cryptogenic bilateral fibrosing pleuritis.
        Br J Dis Chest. 1988; 82: 186-193
        • Venekamp L.N.
        • Velkeniers B.
        • Noppen M.
        Does idiopathic pleuritis exist? Natural history of non-specific pleuritis diagnosis after thoracoscopy.
        Respiration. 2005; 72: 74-78
        • American Thoracic Society
        Diagnoses and initial management of non-malignant diseases related to asbestos.
        American journal of respiratory and critical care medicine volume. 2004; 170: 691-715