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At least 127 records · Page 7Linked to original sources
PubMed1983

The influence of inflation levels of the lung on the morphology of the visceral pleura.

The visceral pleura was shown ultrastructurally to be a tightly adhering covering which follows closely the contour of the underlying lung parenchyma. The outer mesothelial layer was comprised of flattened cells when the lung was inflated and transformed into regions of more cuboidal cells after lung collapse. The only distinguishing factors between the visceral pleura of the younger and older animals were the increased connective tissue in the submesothelial areas of the latter and the increased numbers of vesicles found in their basal lamina. The varying degrees of lung inflation can result in marked alterations in the characteristics of the mesothelial layer of the visceral pleura.

Aging↗
PubMed1982

[Closure of pleura and lung lesions with fibrin adhesive. Experimental studies].

The effect of the fibrin adhesive on the gas density of pleura-lung-sutures was investigated in 28 male Wistar rats. Standardized pleura-lung-lacerations were closed by additional fibrin adhesive application in combination with fibrinolytic inhibitors. 30 minutes and 5 days after operation the animals were sacrificed and manometric and micromorphological examinations performed. In good histo-compatibility the additional application of the fibrin adhesive proved to be a proper technique in elevating the pressure tolerance of pleura-lung-sutures significantly.

Animals↗
PubMed1994

[Radiological approach to the pleura and pleural cavity with CT and MRI].

We discuss the efficacy and limitations of CT and MRI in the assessment of the pleura and pleural cavity. With CT and MRI findings from 610 patients, we address six topics: 1) Normal anatomy of the pleural cavity, 2) Pleural effusion, 3) Pleural tumors, 4) Pyothorax, 5) Lung cancer, and 6) The pleura as a mirror of systemic diseases. CT showed specific findings of acute bleeding. MRI was sensitive enough for the diagnosis of subacute bleeding and chylothorax. In the evaluation of pleural tumors, CT and MRI revealed specific evidence of pedunculated localized fibrous tumors and lipomas. In long-standing pyothorax, it is important to detect any associated secondary malignancies. CT and MRI show as a mass penetrating the bony thorax. B-cell non-Hodgkin malignant lymphoma is the most commonly associated malignancy. The sensitivities for diagnosis of pleural extension of bronchogenic carcinoma are 80% with CT and 86% with MRI. The specificities are 89% with CT and 75% with MRI. To study the pleura as a mirror of systemic diseases, we used high resolution CT to examine 104 patients without evidence of the diseases mentioned above. Eighteen of those 104 patients were found to have pleural thickening, and all 18 were smokers. Of the 24 non-smokers, none had pleural thickening. The difference in the occurrence of pleural thickening between smokers and non-smokers was significant (p < 0.01).

Humans↗
PubMed1995

[Hydraulic conductivity of the visceral pleura with hemodynamic lung edema in dogs].

Hydraulic conductivity of the visceral pleura was measured in situ in anesthetized dogs. There were two groups: control (n = 7), and edema (n = 5). The 7th intercostal space of the left thorax was opened. In each group, a hemispherical capsule, filled with physiological salt solution, was attached to the visceral pleura of left lobe by negative pressure made with a vacuum pump. In the edema group, pulmonary venous pressure was increased by ligation of the pulmonary vein. The transpleural fluid flow (V) was measured at different intracapsular pressures (delta P). The hydraulic conductivity was calculated from the relation between the fluid flow rate (v) and the intracapsular pressure, i.e., the slope of the linear regression line. The hydraulic conductivities in the control and edema groups were 1.49 +/- 0.68 and 3.19 +/- 1.13 nL.min-1.cmH2O-1.cm-2, respectively. We conclude that the pleural tissue may play an important role in hydraulic conductivity of the visceral pleura when pulmonary venous pressure is high.

Animals↗
PubMed1997

[A case of empyema with a bronchopleural fistula treated by a pedicle muscle flap with the thick parietal pleura].

A 65-year-old male with a bronchopleural fistula of 10 mm in diameter underwent thoracoplasty combined with a pedicle muscle flap following open thoracic window. He had been treated by gastrectomy and right upper lobectomy because of gastric perforation and lung tuberculosis before empyema. Sterilization for the empyema cavity through the thoracic window was done for 255 days, obliteration of the empyema cavity was achieved by a muscle flap with the thick parietal pleura. The parietal pleura which was not separated from the intercostal pleura which was not separated from the intercostal muscle was used for reinforcement of the muscle flap against the high intra-tracheal pressure. There was no postoperative relapse of empyema for 9 months.

Aged↗
PubMed1996

Concomitant malignant mesothelioma of the pleura, peritoneum, and tunica vaginalis testis.

We describe the cytohistological, immunohistochemical and ultrastructural findings in a 55-yr-old-man with history of asbestos exposure and diffuse malignant mesothelioma (DMM) of the pleura, peritoneum, and tunica vaginalis presenting with chest pain and scrotal swelling. Pleural fine-needle aspiration (FNA) revealed mesenchymal elements and spindle-shaped epithelial-like cells, while biopsy showed pure sarcomatous tumor invading lung parenchymal. In both samples tumor cells coexpressed cytokeratin and vimentin. Peritoneal and hydrocele effusions contained aggregates of malignant mesothelial cells. Electron microscopy showed intermediate filaments, rare desmosomes and sparse microvilli. Morphological findings were consistent with a DMM, with a biphasic pattern in the pleura and an epithelial one in the peritoneum and tunica vaginalis. Although the possibility of a multicentric origin cannot be ruled out, clinical chronologic sequence suggests that the pleura was the primary involved site, followed by spread to peritoneum and tunica vaginalis.

Asbestos↗
PubMed1989

Pleural mesothelioma of connective tissue type, localized fibrous tumour of the pleura, and reactive submesothelial hyperplasia. An immunohistochemical comparison.

Ten diffuse pleural mesotheliomas of connective tissue type have been compared with 14 examples of pleural granulation tissue and 7 localized fibrous tumours of the pleura, using immunohistochemistry to identify cytokeratins of low and high molecular weight and vimentin. Low molecular weight cytokeratin and vimentin were both detected in 8 of the 10 mesotheliomas and in 12 of the 14 reactive lesions. High molecular weight cytokeratin was rarely detected in either lesion. The seven localized fibrous tumours of the pleura were all positive for vimentin and negative for both cytokeratins. These findings support an origin of connective tissue type mesotheliomas from multipotential submesothelial spindle cells and of localized fibrous tumours of the pleura from either conventional fibroblasts or resting submesothelial spindle cells. Antibodies to cytokeratin help distinguish these two neoplasms but provide no assistance in the more difficult diagnostic problem of distinguishing mesotheliomas of connective tissue type from pleural reactions characterized by abundant granulation tissue.

Antibodies↗
PubMed1998

Video-assisted thoracoscopic excision of a benign cystic mesothelioma of pleura.

We are reporting on the case of a 44-year-old woman upon which video-assisted thoracoscopic excision of a benign cystic mesothelioma of the pleura was performed. To our knowledge, this is the second report on a case of a benign cystic mesothelioma of the pleura. The cyst in our case was solitary and was easily excised. Microscopic examination revealed that the cyst was lined by a single layer of flattened and cuboidal cells. Immunohistochemical analysis revealed that the cells lining the cyst stained positively for keratin and negatively for factor VIII-related antigen. Benign cystic mesothelioma of the pleura was diagnosed based on histological findings. For seven months her condition has been monitored at our out-patient clinic with no signs of recurrence. However, continued careful observation is required because benign cystic mesothelioma often recurs locally. Local recurrence is thought to be related to incomplete resection of the tumor. Therefore, careful observations and techniques to ensure complete resection of the cyst, are important during video-assisted thoracoscopic surgery.

Adult↗
PubMed2003

Malignant solitary fibrous tumor of the pleura: report of a case with cytogenetic analysis.

The majority of solitary fibrous tumors (SFTs) of the pleura are benign, but 10-30% locally recur or metastasize. Pathogenic factors relevant to the determinism of their biological properties are largely unknown. Cytogenetic data on SFTs of the pleura are sparse. We report herein a case of a malignant SFT of the pleura where successful karyotyping was obtained from the primary and recurrent tumors. The initial karyotype showed two abnormal clones: 48, XY; +8; +8; del(9)(q22; q32) [19] and 46, XY, t(1;16)(q25;p12) [7]. Culture of the recurrent tumor yielded one clone identical to the dominant clone of the initial karyotype. Demonstration of a recurrent abnormal karyotype largely supports its relevance to the malignant clone and suggests a role of supernumerary chromosome(s) 8 in the determinism of malignant behavior in SFT.

Aneuploidy↗
PubMed2004

Huge localized fibrous tumor of the pleura resembling a mediastinal tumor: report of a case.

A 67-year-old man was admitted to our hospital because of an abnormal chest echoic lesion detected incidentally by echocardiography. A chest roentgenogram showed the presence of a giant mass, and computed tomography of the chest confirmed the presence of a mass with a nonhomogeneous density in the left mediastinum, just adjacent to the left ventricle of the heart. Percutaneous aspiration cytology of the mass showed benign fibrous cells and a small amount of lymphocytes. The preoperative diagnosis of the tumor suggested a thymoma, and the patient underwent a thoracotomy. A pedunculated tumor arose from the visceral pleura of the left upper lobe of the lung, and it was capsulated within the pleura. The tumor measured 15 x 12 x 8 cm in size and it was successfully resected. The pathological diagnosis of the tumor was benign localized fibrous tumor of the pleura.

Aged↗
PubMed2006

CT features of solitary fibrous tumour of the pleura: experience in 26 patients.

PURPOSE: The purpose of this study was to identify the typical computed tomography (CT) features of solitary fibrous tumours of the pleura (SFTP) and determine which findings would allow confirmation of the pleural origin or benign behaviour of the tumour. MATERIALS AND METHODS: Twenty-six preoperative CT studies of the chest (23 enhanced and 14 unenhanced) were retrospectively reviewed. RESULTS: Up to 50% of SFTP were larger than 10 cm. At unenhanced CT, they showed homogeneous attenuation in 5 cases (35.7%) and inhomogeneous attenuation in 9 (64.3%). At contrast-enhanced CT, they were inhomogeneous in 21 cases (91.3%), with geographic pattern (61.9% of cases), serpiginous linear areas of enhancement (intralesional vessels) (23.8%), rounded (52.4%) or linear (33.3%) areas of low attenuation (necrosis). CONCLUSIONS: Depending on location, size and histological features, SFTP may produce a large spectrum of findings. Typical CT features of small SFTP were well-defined margins and smooth contours, homogeneous attenuation and right or obtuse angles with the pleura. Larger lesions were characterised by well-defined margins and lobulated contours, geographic pattern in enhanced CT scans, acute angles or smooth tapering margins with the pleura.

Adult↗
PubMed2000

Fibrous tumors of the pleura.

Fibrous tumor of the pleura is a rare tumor arising from mesenchymal cells underlying the visceral or parietal pleura. The tumor may have benign or malignant histological features, but these do not always predict the clinical behavior of the tumor. In most cases, the tumor appears pedunculated, and simple resection of the tumor is curative even if significant cellular atypia is present. In contrast, some tumors with a broad base of attachment may recur and occasionally become malignant. Complete surgical resection is the mainstay of therapy for both benign and malignant fibrous tumors of the pleura. When resection is incomplete or impossible, external radiation therapy with or without chemotherapy is recommended.

Antineoplastic Agents↗
PubMed2005

Solitary fibrous tumors of the pleura: surgical outcome and clinical course.

BACKGROUND: The aim of this study was to define more precisely the surgical outcome and clinical course of solitary fibrous tumors of the pleura. METHODS: We conducted a retrospective review of the clinical records of patients who had undergone surgical resection for benign and malignant solitary fibrous tumors of the pleura during a 10-year period (1993 to 2003). RESULTS: Sixty-three patients were enrolled in the study (men, 29; women, 34; mean age, 49.6 years). Thirty-six patients (57.1%) were symptomatic at the time of diagnosis. Resection was performed through a thoracotomy (n = 37), by means of video-assisted thoracoscopy (n = 22), or through a sternotomy (n = 4). Mass excision only was performed in 34 cases, and en bloc excision including adjacent structures was performed in 29 cases. Forty-four cases (69.8%) were benign and 19 (30.2%) were malignant. Local recurrences occurred in three cases and distant metastases in eight. Recurrences occurred only in malignancy. Symptomatic presentation and the impression of a nonpleural tumor by imaging study were found to be related to a malignant pathologic diagnosis. The radiologic impression of solitary fibrous tumors of the pleura was also related to mass excision only. CONCLUSIONS: For malignant cases, complete surgical resection may be insufficient for the cure. Therefore, further study should be performed to define the role of preoperative and postoperative systemic treatment.

Adolescent↗
PubMed2006

Giant localized fibrous tumours of the pleura: report of three subsequent cases.

Localized fibrous tumours of the pleura (LFTP) represent clinical entities rarely encountered, especially in giant forms. We report of three cases of giant localized fibrous tumours of the pleura found last year in a short time. The patients underwent surgery by thoracotomy. All tumours arose from visceral pleura and were radically excised by a wedge resection of the lung. The patients discharged from the hospital after a short postoperative period without complications. Two of three giant localized fibrous tumours were classified as benign forms; in one case a malignant characteristic was found.

Adult↗
PubMed2001

Visceral pleura invasion by non-small cell lung cancer: an underrated bad prognostic factor.

BACKGROUND: Visceral pleura invasion (VPI) by non-small cell lung cancer is a factor of poor prognosis. A tumor of any size that invades the visceral pleura is classified as T2. Few studies have been conducted concerning the prognostic significance of VPI relative to other staging factors. METHODS: Between April 1984 and December 1996, 1,281 patients with T1 (n = 430) and T2 (n = 851) non-small cell lung cancer underwent curative surgical resection. Adjuvant radiation therapy was performed in 455 patients. There were 176 women and 1,105 men aged 30 to 86 years (mean, 60.9 years). Five hundred nineteen pneumonectomies, 742 lobectomies, and 20 segmentectomies were performed. In all patients, a complete mediastinal lymph node dissection was performed. International staging was stage IA and B (n = 697); stage II A and B (n = 247), and stage III A (n = 337). The patients were divided into two groups according to the existence of VPI (group I without, group II with). Both groups were compared with regard to the size of the tumors, histology, associated lymph node involvement, survival rates, and cause of death. Univariate and multivariate analyses were conducted. RESULTS: VPI (group II) was identified in 19.1% of the resected specimens: group I, n = 1036; group II, n = 245. The VPI was present in only 10% of non-small cell lung cancer 3 cm or less in size, reaching 33% of patients with non-small cell lung cancer larger than 5 cm (p = 0.0001). Squamous non-small cell lung cancer were significantly less accompanied by VPI (13.5%) than the other histologic categories. The VPI was associated with a higher frequency of N2 involvement (group I = 24.6%, group II = 33.4%, p = 0.01) and N2 involvement was more extensive (two or more N2 involved stations: group I = 8.2%, group II = 15.6%, p = 0.003). Actuarial survival rates were 51.8% at 5 years and 33.8% at 10 years in group I (median, 66 months), and 34.6% at 5 years and 27.9% at 10 years in group II (median, 30 months) (p = 0.000002). Long-term survival rates significantly decreased for larger tumors. Even in patients with N2 stage tumors, the difference of survival curves between the two groups was statistically significant. Cancer-related deaths were more frequent in group II and were mainly caused by distant metastases. By multivariate analysis, visceral pleura invasion proved to be a significant independent factor of poor prognosis. CONCLUSIONS: The VPI is a factor of poor prognosis. Its frequent association with extensive N2 involvement supports the hypothesis that exfoliated tumor cells are drained through the pleural lymphatics by the mediastinal lymphatic pathways and then into the bloodstream. The VPI is an important prognostic factor and, as such should stimulate more studies to better select the patients who could benefit from adjuvant therapy.

Adult↗
PubMed2002

Solitary fibrous tumors of the pleura.

Solitary fibrous tumor of the pleura is a mesenchymal tumor that has been increasingly recognized over the past few years. The tumor was initially described in the pleura, but it has been reported in many other sites lately. Although the majority of these tumors have a benign course, the malignant form still remains enigmatic. Indeed, the behavior of these tumors is often unpredictable and does not always correlate with histologic findings. In addition, benign tumors may remain unproblematic for several years before changing into a malignant form. In order to define more precisely the clinical behavior of solitary fibrous tumors of the pleura, we reviewed the literature with particular attention to the clinical presentation, histopathologic characteristics, and cytogenetic differentiation of these tumors. A staging system and an algorithm for the management and follow-up of these patients are proposed.

Algorithms↗
PubMed2000

Malignant epithelioid vascular tumors of the pleura: report of a series and literature review.

Primary malignant vascular tumors of the pleura are rare. The significance and difficulty of distinction between pleural epithelioid hemangioendothelioma (EHE) and angiosarcoma have not yet been addressed. A new series of pleural angiosarcoma is reported, and the relevant literature is reviewed. Five cases were identified from files of the authors' institutions and personal consultation cases (J.J.B.). Twenty-six cases of primary malignant vascular tumors of the pleura were identified in the literature. In a total of 31 cases, 22 were from the West and 9 from Japan. Patients were 22 to 79 years old (average, 57), and the male/female ratio was 9:1. Prior chronic pyothorax was identified only in cases reported from Japan. History of exposure to radiation or asbestos was noted in a few Western cases. The most common presentation was pleural thickening and effusion. Almost all of the patients died of disease shortly after diagnosis. A spectrum of histology ranging from characteristic high-grade epithelioid to relatively low-grade EHE-like features was observed in our cases and can be found in previous reports. Most cases showed variable spotty cytokeratin immunoreactivity. Endothelial markers (factor 8, CD34, or CD31) were invariably positive. Pleural angiosarcomas are often epithelioid and can be easily mistaken for mesothelioma or carcinoma clinically and histologically. Awareness of this rare tumor should prompt the use of endothelial markers when faced with a questionable mesothelioma. When cytokeratin is negative, or focal with strong vimentin reactivity, a vascular tumor should be suspected and confirmed with vascular markers. Because of their invariably aggressive behavior, all epithelioid vascular tumors of the pleura should be considered highly malignant regardless of the presence of EHE-like histological features.

Adult↗
PubMed2005

[Hypoglycemic coma revealing a solitary fibrous tumor of the pleura].

INTRODUCTION: Solitary fibrous tumor of the pleura (TFSP) is rare. When associated with hypoglycemia it is commonly referred to as Doege-Potter syndrome. CASE: A 51-year-old man was hospitalized for recurrent near-syncope associated with hypoglycemia. Clinical examination and then thoracic imaging clearly showed anomalies that corresponded to a mass occupying the entire left hemithorax. After resection, histological analysis diagnosed a fibrous tumor of the pleura. DISCUSSION: Solitary fibrous tumors of the pleura are observed most often in patients aged 50 and 70 years. Hypoglycemia is rare, occurring in approximately 4% of cases. It is explained by the abnormal secretion of a type-II insulin-like growth factor. This tumor is treated by complete surgical excision.

Coma↗