PMC6713890_01
(A) Day 1: Lateral left sided thoracic radiograph view: Markedly increased soft- tissue opacity with completely silhouetted cardiac silhouette and retracted lung lobes due to a severe pleural effusion. (B,C) Day 1: Lateral left sided and ventrodorsal thoracic radiograph view: After needle thoracocentesis lung lobes were severely rounded and expanded to ~40%. Heterogenous pleural thickening is present. The heart is detached from the sternum. An iatrogenic pneumothorax was suspected. (D,E) Day 3: Lateral left sided and ventrodorsal thoracic radiograph view: Chest tubes are placed bilaterally. Lung lobes are re-expanded to 80% on the left and to 60% on the right side. Sternal lymphnode (asterisk) is prominent and a precardial mass-effect (arrow) is seen. The latter is suggestive for fibrotic tissue.
fvets-06-00278-g0001.jpg
PMC6713890_01_fvets-06-00278-g0001.jpg
F1
After initial stabilization, a left sided thoracic radiograph revealed severe pleural effusion (Figure 1A). Marked pleural thickening of all lung lobes was present (Figures 1B,C). Despite clinical improvement at day three, there was no re-expansion of the lung lobes (Figures 1D,E).
(A,B) Day 3: Computer tomography: Heterogenous pleural thickening of multiple lung lobes is seen. The right middle lung lobe is severely atrophic and atelectatic (asterisk). The remaining lung lobes are expanded to ~40% on the right side. Left lung lobes are nearly completely re-expanded on the left side. Mild pleural effusion is present (right > left).
fvets-06-00278-g0002.jpg
PMC6713890_01_fvets-06-00278-g0002.jpg
F2
Mild pleural effusion (right > left) was present (Figures 2A,B).
(A,B) Day 6: Lateral left sided and ventrodorsal thoracic radiograph view: Lung lobes re-expanded to 80% on the left and right side. Titanum clips are present on the height of the right middle lung lobe. On the left side a chest tube is placed. Pleural thickening is present in all remaining lung lobes. Cardiac silhouette is slightly detached from the sternum. (C,D) Day 18: Lateral left sided and ventrodorsal thoracic radiograph view: Moderate increased soft- tissue opacity with partially silhouetted cardiac silhouette. Lung lobes are mildly retracted (90% re-expansion). On the left side a chest tube is present. (E,F) Day 24: Lateral left sided and ventrodorsal thoracic radiograph view: After needle thoracocentesis: Lung lobes are expanded to ~80% on the left and 70% on the right side. Heterogenous pleural thickening of the remaining lung lobes is seen. (G,H) 4 months later: Lung lobes are re-expanded to 95% on both thoracic sides. Mild pleural fibrosis is present. Mild fluid accumulation is seen. (I,J) 15 months later: Lateral left sided and ventrodorsal thoracic radiograph view: Complete re-expansion of all lung lobes. Mild pleural fibrosis is still present. Material of soft-tissue opacity is seen overlaying the cardiac silhouette. Fine needle aspiration revealed the presence of fibrotic tissue. Fluid accumulation could be excluded by ultrasonography.
fvets-06-00278-g0003.jpg
PMC6713890_01_fvets-06-00278-g0003.jpg
F3
Chest tube functionality was assessed clinically, by measurement of produced fluid, active suction q24h and by thoracic radiographs (Figures 3A,B). Lungs re-expanded to ~80% 6 days after surgery (Figures 3A,B). Pleural effusion persisted for 4 months (Figures 3C-H). Pleural effusion was evident neither on radiographs (Figures 3I,J) nor by ultrasonography.