PDF(Pubmed)
Abstract：
Parapneumonic pleural effusions are common in patients with pneumonia. When colonized by pathogenic bacteria or other microorganisms, these effusions can progress to empyema. Additionally, empyema formation may result in extension of the infection into the infradiaphragmatic region, further complicating the clinical scenario. Many subphrenic collections are found to be mesothelial cysts, which are congenital in origin. However, data regarding the potential association between mesothelial diaphragmatic cysts and parapneumonic effusions are limited. We herein describe a toddler with pneumonia complicated by parapneumonic effusion and a lung abscess with a subphrenic collection. After abscess drainage and a full course of antibiotics, imaging revealed clear lung parenchyma with an interval resolution of the effusion and a persistent unchanged subphrenic collection that was confirmed to be mesothelial diaphragmatic cyst. This case highlights the fact that not every subphrenic collection associated with parapneumonic effusion is a communicated collection formed by seeding. Such a collection can instead be an incidental cyst, which is congenital in origin and known as a mesothelial diaphragmatic cyst. A diaphragmatic mesothelial cyst is an uncommon benign congenital cyst that is unrelated to an adjacent parapneumonic effusion. It is usually incidental and can be monitored without invasive intervention.
摘要：
肺炎旁胸腔积液在肺炎患者中很常见。当被病原细菌或其他微生物定植时，这些积液可以进展为脓胸。此外,脓胸形成可能导致感染扩展到膈肌区域，进一步复杂的临床情况。许多膈下集合被发现是间皮囊肿，这是先天性的。然而,关于间皮膈囊肿和肺炎旁积液之间潜在关联的数据有限.我们在此描述了患有肺炎并伴有肺炎旁积液和肺脓肿的幼儿。脓肿引流和全疗程抗生素后，影像学显示肺实质清晰，积液间期消退，膈下仍有持续的未改变，证实为间皮膈囊肿。此案例突显了这样一个事实，即并非与肺炎旁积液相关的每个膈下集合都是通过播种形成的交流集合。这样的集合可以是偶然的囊肿，这是先天性的，被称为间皮膈囊肿。膈间皮囊肿是一种罕见的良性先天性囊肿，与相邻的肺炎旁积液无关。它通常是偶然的，可以在没有侵入性干预的情况下进行监测。
