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Pneumonectomy
Allen Heeger, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Intrapleural pneumonectomy (IPP)
              • Extrapleural pneumonectomy (EPP)
              • Bronchopleural fistula (BPF)
            • Synonyms

              • Intrapleural (classic) pneumonectomy
            • Definitions

              • Intrapleural (classic) pneumonectomy: Lung and visceral pleural resection
                • Treatment of lung cancer, tuberculosis, bronchiectasis
              • EPP: En bloc resection of lung, visceral and parietal pleura, hemidiaphragm, and pericardium
                • Used in young patients with curative intent for select malignancies: Malignant pleural mesothelioma, locally advanced lung cancer, high-risk (invasive) thymoma
              • Intrapericardial pneumonectomy: IPP with resection of pericardial invasive disease or intrapericardial portions of pulmonary vasculature
              • Sleeve pneumonectomy: Central tumor resection; contralateral mainstem bronchus anastomosed to trachea

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        CLINICAL ISSUES

                        • Presentation

                          • Natural History & Prognosis

                            • Treatment

                              Selected References

                              1. Lo EYW et al: Balanced chest drainage prevents post-pneumonectomy pulmonary oedema. Heart Lung Circ. 29(12):1887-92, 2020
                              2. Duranti L et al: Extra-pleural pneumonectomy. J Thorac Dis. 11(3):1022-30, 2019
                              3. Bommart S et al: Imaging of postoperative complications following surgery for lung cancer. Diagn Interv Imaging. 98(1):11-20, 2017
                              4. Bommart S et al: Normal postoperative appearances of lung cancer. Diagn Interv Imaging. 97(10):1025-35, 2016
                              5. Alpert JB et al: Imaging the post-thoracotomy patient: anatomic changes and postoperative complications. Radiol Clin North Am. 52(1):85-103, 2014
                              6. Weder W et al: Carinal resection and sleeve pneumonectomy. Thorac Surg Clin. 24(1):77-83, 2014
                              7. Wolf AS et al: Extrapleural pneumonectomy for pleural malignancies. Thorac Surg Clin. 24(4):471-5, 2014
                              8. Pool KL et al: Radiographic imaging features of thoracic complications after pneumonectomy in oncologic patients. Eur J Radiol. 81(1):165-72, 2012
                              9. Kim DJ et al: Long-term survival following pneumonectomy for non-small cell lung cancer: clinical implications for follow-up care. Chest. 132(1):178-84, 2007
                              10. Mehanna MJ et al: Cardiac herniation after right pneumonectomy: case report and review of the literature. J Thorac Imaging. 22(3):280-2, 2007
                              11. Chae EJ et al: Radiographic and CT findings of thoracic complications after pneumonectomy. Radiographics. 26(5):1449-68, 2006
                              12. Kim SY et al: Filling defect in a pulmonary arterial stump on CT after pneumonectomy: radiologic and clinical significance. AJR Am J Roentgenol. 185(4):985-8, 2005
                              13. Kwek BH et al: Postpneumonectomy pulmonary artery stump thrombosis: CT features and imaging follow-up. Radiology. 2005
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Top Differential Diagnoses

                                    • Clinical Issues

                                      • Diagnostic Checklist

                                        TERMINOLOGY

                                        • Abbreviations

                                          • Intrapleural pneumonectomy (IPP)
                                          • Extrapleural pneumonectomy (EPP)
                                          • Bronchopleural fistula (BPF)
                                        • Synonyms

                                          • Intrapleural (classic) pneumonectomy
                                        • Definitions

                                          • Intrapleural (classic) pneumonectomy: Lung and visceral pleural resection
                                            • Treatment of lung cancer, tuberculosis, bronchiectasis
                                          • EPP: En bloc resection of lung, visceral and parietal pleura, hemidiaphragm, and pericardium
                                            • Used in young patients with curative intent for select malignancies: Malignant pleural mesothelioma, locally advanced lung cancer, high-risk (invasive) thymoma
                                          • Intrapericardial pneumonectomy: IPP with resection of pericardial invasive disease or intrapericardial portions of pulmonary vasculature
                                          • Sleeve pneumonectomy: Central tumor resection; contralateral mainstem bronchus anastomosed to trachea

                                        IMAGING

                                        • General Features

                                          • Radiographic Findings

                                            • CT Findings

                                              • Nuclear Medicine Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          Selected References

                                                          1. Lo EYW et al: Balanced chest drainage prevents post-pneumonectomy pulmonary oedema. Heart Lung Circ. 29(12):1887-92, 2020
                                                          2. Duranti L et al: Extra-pleural pneumonectomy. J Thorac Dis. 11(3):1022-30, 2019
                                                          3. Bommart S et al: Imaging of postoperative complications following surgery for lung cancer. Diagn Interv Imaging. 98(1):11-20, 2017
                                                          4. Bommart S et al: Normal postoperative appearances of lung cancer. Diagn Interv Imaging. 97(10):1025-35, 2016
                                                          5. Alpert JB et al: Imaging the post-thoracotomy patient: anatomic changes and postoperative complications. Radiol Clin North Am. 52(1):85-103, 2014
                                                          6. Weder W et al: Carinal resection and sleeve pneumonectomy. Thorac Surg Clin. 24(1):77-83, 2014
                                                          7. Wolf AS et al: Extrapleural pneumonectomy for pleural malignancies. Thorac Surg Clin. 24(4):471-5, 2014
                                                          8. Pool KL et al: Radiographic imaging features of thoracic complications after pneumonectomy in oncologic patients. Eur J Radiol. 81(1):165-72, 2012
                                                          9. Kim DJ et al: Long-term survival following pneumonectomy for non-small cell lung cancer: clinical implications for follow-up care. Chest. 132(1):178-84, 2007
                                                          10. Mehanna MJ et al: Cardiac herniation after right pneumonectomy: case report and review of the literature. J Thorac Imaging. 22(3):280-2, 2007
                                                          11. Chae EJ et al: Radiographic and CT findings of thoracic complications after pneumonectomy. Radiographics. 26(5):1449-68, 2006
                                                          12. Kim SY et al: Filling defect in a pulmonary arterial stump on CT after pneumonectomy: radiologic and clinical significance. AJR Am J Roentgenol. 185(4):985-8, 2005
                                                          13. Kwek BH et al: Postpneumonectomy pulmonary artery stump thrombosis: CT features and imaging follow-up. Radiology. 2005