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At least 163 records · Page 9Linked to original sources
PubMed1987

Notifiable malignant lesions in the RSA, 1979-1983--trends and mortality. II. Primary malignant neoplasms of the pleura.

From August 1979 to December 1983, 22 cases of and 17 deaths due to primary malignant neoplasms of the pleura were notified to the Department of National Health and Population Development. Correspondingly, 458 deaths due to mesothelioma and malignant neoplasms of the pleura were registered at Central Statistical Services; 4% of these deaths were notified. Most of the deaths due to mesothelioma and malignant neoplasms of the pleura registered were in white males, who showed a mortality rate of 15.8/1,000,000.

Adult↗
PubMed1983

[5 new cases of solitary fibrous mesothelioma of the visceral pleura].

Five new cases of solitary fibrous mesothelioma of the visceral pleura support this review of the literature. Well encapsulated, mostly pedunculated, the implantation on the visceral pleura remains asymptomatic for a very long time and is more likely to be an incidental finding on a chest radiograph. Two extrathoracic signs are associated with certain huge tumors : hypoglycemia and osteoarthropathy. Histologic examination discloses whorls of collagen with scattered spindle-shaped cells. Electron microscope reveals characteristic features of both fibroblasts and mesothelial cells. Complete surgical removal is the best treatment for localized fibrous mesotheliomas of the visceral pleura. Recurrences after resection are rare and late recurrence, as long as 16 years after initial excision, usually behaves in a benign fashion.

Adult↗
PubMed1997

[A case of malignant mesothelioma of the pleura and the peritoneum detected by sudden onset of back pain and pleural effusion and ascites].

A case of malignant mesothelioma of the pleura and the peritoneum is reported. In April 1996, a 40-year-old men noticed sudden onset of back pain. Radiographic examinations and MRI revealed pleural effusions, ascites, ringed enhanced tumorous lesions in the right posterior diaphragm along the abdominal aorta, and marked thickening of the right diaphragm with moderate signal intensity. On thoracoscopic surgery, there were white small nodules on the intercostal parietal pleura. Tumor cells of a tubulopapillary pattern had large rounded nuclei and eosinophilic cytoplasms in a partially glandlike arrangement. Cytoplasms of tumor cells stained for alcian blue disappeared after hyaluronidase digestion. Immunohistochemical examinations showed positive staining for keratin but negative for CEA. Electron micrographs showed numerous long thin microvilli, desmosomes and intermediate tonofilaments. From these findings, malignant mesothelioma was diagnosed. The malignant mesothelioma cells of the pleura in this case were considered to disseminate the peritoneum directly through the diaphragm or its lymphatic canals. MRI and thoracoscopic surgery were useful for the demonstration of the pleural disseminations and abdominal invasions.

Adult↗
PubMed2005

Bilateral congenital diaphragmatic hernia with absent pleura and pericardium.

BACKGROUND: Bilateral congenital diaphragmatic hernia is a rare form of diaphragmatic hernia. Independently, pericardial defects are an extremely rare phenomenon. In the case presented, we provide the first complete description of an infant with bilateral congenital diaphragmatic hernia with complete agenesis of the pericardium and inferior parietal pleura. CASE: A male infant was born at 38 weeks of gestation with a prenatal diagnosis of left-sided congenital diaphragmatic hernia. After 1 week of aggressive management, the patient was taken to the operating room for repair. Intraoperatively, the patient was found to have absence of the diaphragm bilaterally, no pleura inferiorly, and no pericardium. A biological mesh was used to construct a diaphragm. At 6 months of age, the patient is growing normally, requiring only supplemental oxygen without pressure support. CONCLUSIONS: Embryologically, this anomaly represents complete lack of development of the pleurocardial folds, pleuroperitoneal folds, and transverse septum, which is previously unreported.

Abnormalities, Multiple↗
PubMed1991

[Light and scanning electron microscopy studies of the pleura. A contribution to the pathogenesis of spontaneous pneumothorax in young patients].

In a prospective study of 10 patients (7 men, 3 women, mean age 26.2 years), who underwent thoracotomy because of recurrent spontaneous pneumothorax, we performed light and scanning electron microscopic investigations of the resected pleura. The purpose of our work was to explain pleural changes which allowed the penetration of air through the intact wall of the blebs. In 8 of 10 cases we found small bullae at the top of the upper lobe, the remaining 2 showed up with massive pleural scar. The morphological and ultrastructural findings indicated that the presence of air induced a reactive process at the visceral pleura which led to degeneration and scarification. The changes consisted of simple membrane formation up to complete destruction of the pleural layer. The development of blebs is due to an air fistula coming out of the lung parenchyma. Penetration of air through the bleb's wall is explained with the increasing pressure inside and the dehiscence of degenerated pleural structure. In our opinion spontaneous pneumothorax in young people is caused by a localized disease of the upper lobe. The pleural changes are the visible effects of a degenerative process induced by air fistula from lung parenchyma. Therefore wedge-resection of that region is a rational therapy in patients with spontaneous pneumothorax.

Adult↗
PubMed2000

Malignant solitary fibrous tumor in the pleura.

We present a case of malignant solitary fibrous tumor of the pleura in an asymptomatic 75-year-old man. A needle biopsy specimen revealed a solitary fibrous tumor of the pleura with suspected. The tumor was resected and the final diagnosis was a malignant solitary fibrous tumor. At one-and-a-half years later, the patient has no clinical or radiological evidence of recurrence. The propriety of a needle biopsy for preoperative diagnosis is discussed.

Aged↗
PubMed2000

[Paraneoplastic hypoglycemia in localized fibrous tumors of the pleura].

Localized fibrous tumor of the pleura is a rare, slowly growing, benign tumor which originates from the submesothelial stem cells of the pleura visceralis. Most of these tumors clinically behave asymptomatically, although tumor-associated hypoglycemia occurs in a few cases and can lead to hypoglycemic coma. Laboratory investigations show significant elevation of paraneoplastic IGF-II with a 2-3 times higher effect on the blood glucose level than insulin. Further, one finds reduced synthesis of IGFBP-3, which inhibits the action of IGF-II by inducing a complex with the paraneoplastic protein. As treatment, surgical resection of the tumor is recommended. We report on the case of a 72-year-old man with diabetes mellitus type II, who complained of recurrent hypoglycemic episodes. Diagnostic evaluation showed a fibrous tumor attached to the right diaphragm. After surgical treatment the hypoglycemic episodes disappeared.

Aged↗
PubMed1992

Contributory role of lung pleura to release of anaphylactic mediators from guinea pig lung in response to ovalbumin or A23187.

Previous findings revealed greater contractile responses of guinea pig lung pleural surface strips to antigen or A23187 challenge than denuded lung parenchymal strips (lung strip devoid of any pleura). Moreover, we have identified a high density of mast cells distributed throughout the lung pleura. The present study examined mediators released from guinea pig lung pleural surface and denuded lung parenchyma fragments in response to immunologic challenge with ovalbumin (OA) or non-immunologic challenge with the ionophore A23187. Histamine levels were measured radioenzymatically; leukotrienes (LTs), prostaglandins (PGs) and thromboxane B2 (TXB2), a stable metabolite of thromboxane A2 (TXA2), were quantitated using an enzyme immunoassay. Histamine release reached a maximal level 3-5 min after OA challenge, whereas A23187-induced histamine release increased gradually in a time-dependent manner. Similar kinetics were observed in the release of LTs, PGs and TXA2. Pleural surface released a substantially (P < 0.05) greater amount of histamine to both challenges than denuded parenchyma. Moreover, histamine content in pleural surface was significantly (P < 0.05) higher than in denuded parenchyma. Pleural surface also released considerably (P < 0.05) more LTB4, LTC4, and LTE4 in response to OA and A23187 than denuded parenchyma. In contrast, pleural surface and denuded parenchyma released equivalent amounts of PGD2, PGE2, PGF2 alpha, and TXA2 in response to both challenges. The rank order of leukotriene release was LTC4 > LTE4 > LTB4, whereas that of prostanoid release was TXA2 >> PGD2 > or = PGF2 alpha >> PGE2. We conclude that pleural surface is the major source of histamine and leukotrienes released from guinea pig lung in vitro in response to OA and A23187, whereas both pleural surface and denuded parenchyma participate to the same extent in prostaglandin and TXA2 production after such challenges.

Animals↗
PubMed1992

Viscoelastic properties of the visceral pleura and its contribution to lung impedance.

The mechanical impedances of 10 dog lung lobes (ZL) and circular pleura samples 1.6 cm in diameter (Zpl) were measured with small-amplitude forced oscillations between 0.2 and 4.2 Hz. Two to four samples were ablated from each lobe after their in situ tension had been fixed at 5 cmH2O transpulmonary pressure with plastic rings. Lobe resistance was inversely proportional to frequency (f) and lobe elastance increased linearly with the logarithm of f by 23%/decade. The real part of Zpl (Rpl) decreased hyperbolically with f. Pleural elastance (Epl) showed only a 5%/decade increase with log f. The regional variability of Epl was large and the data allowed the lumping of Epl into only two groups. The variability of Epl was higher in the group of Epl values from the coastal surfaces than in the group of Epl values from any other surfaces (3105 +/- 2741 (SD) vs 2263 +/- 1152 cm H2O/L). The mean intraindividual variation of Epl corresponding to costal and to other surfaces was 38 +/- 25 and 32 +/- 23%, respectively. The hysteresivity index (Fredberg and Stamenovic, J. Appl. Physiol., 67: 2408-2419, 1989) of the pleura was significantly smaller than that of the lobes (0.025 vs 0.148). Extrapolation of Zpl to the entire lobe surface predicted pleural/lobar resistance and elastance ratios of 2.7 +/- 0.4 and 16.8 +/- 10.6%, respectively, at 0.2 Hz, and 0.4 +/- 0.4 and 15.5 +/- 10.6%, respectively, at 4.2 Hz. This suggests that for small deformations and medium lung volumes the pleural contribution to ZL is almost ideally elastic and only slightly frequency-dependent.

Airway Resistance↗
PubMed2006

Pathology of the pleura.

The pleura and lung are intimately associated and share many pathologic conditions. Nevertheless, they represent two separate organs of different embryonic derivation and with different yet often symbiotic functions. In this article, the authors explore the pathologic manifestations of the many conditions that primarily or secondarily affect the pleura.

Adenomatoid Tumor↗
PubMed2005

Functional similarities between pleura and the renal proximal tubule--membrane and cellular considerations.

The small amount of liquid that, under physiological conditions, is presented in the pleural cavity has been the focus of extensive research for more than a century. However, there are still unanswered questions and considerable controversies about the nature of the forces governing its movement into and out of the pleural cavity. Early in the 20th century has been proposed that pleural fluid turnover is simple based on the balance between hydraulic and colloid osmotic pressures existing across the pleural membranes. This original hypothesis has not been validated by data accumulating over the last 20 years. Pleural tissues and renal proximal tubules present high water permeability, small transepithelial electrical resistance (22.02 Omega cm2) and the same cation transportation such as Na+ channels, Na+-K+ ATPase channels, and Na+-H+ exchanger. In contrast to previous conflicting theories concerning pleura fluid movement, the same functional characteristics suggest the hypothesis that physiology of pleura is similar to proximal tubules.

Animals↗
PubMed1998

Nerve fibers--mast cells correlation in the rat parietal pleura.

Our results show that a morphological correlation exists between catecholaminergic nerve fibers and mast cells in the rat parietal pleura. Mast cells are found in proximity to catecholaminergic nerve fibers. Moreover we have demonstrated that mast cells and nerve fibers in the perivascular areas of rat parietal pleura show the same formaldehyde fluorescence. In rats previously sympathectomized with neurotoxin 6-OHDA the nerve fibers appear disarranged and poorly fluorescent and related mast cells show a low fluorescence. The importance of this correlation and the possible role of mast cells are discussed.

Animals↗
PubMed1979

Biosynthesis of prostaglandin (PGI2) and 12L-hydroxy-5,8,10,14-eicosatetraenoic acid (HETE) by pericardium, pleura, peritoneum and aorta of the rabbit.

Prostacyclin generation by pericardium, pleura, peritoneum, aorta and dura mater of the rabbit was assessed as platelet aggregation inhibitory activity in platelet rich plasma. All tissues except the dura mater, were also incubated with labelled (1-14C) arachidonic acid and (1-14C) prostaglandin endoperoxide H2 and the various metabolites formed were identified radiochromatographically. Pericardium, pleura and peritoneum form substantially high amounts of prostacyclin and HETE indicating that these tissues contain both cyclo-oxygenase and prostacyclin-synthetase. They also show considerable lipoxygenase activity.

Animals↗
PubMed1997

Organization of collagen and elastic fibers studied in stretch preparations of whole mounts of human visceral pleura.

Fibers of the collagenous and elastic systems are most relevant in the double mechanical action of visceral pleura (VP), i.e. volume limitation and the generation of elastic recoil pressure. In this work we studied the organization of these fibrous components of VP in two situations: normal lungs and bullous disease. We employed histochemical methods on conventional histological slides and on thin spreads of whole mounts of visceral pleura. In addition, the scanning electron microscope was also used. According to our results, pleural function is made possible by the combination of both the elastic and collagenous fiber systems, each one having as intrinsic organizational pattern. Marked alterations of pleural bullous structure are observed with changes in lung volume. Fibers of the elastic and collagenous systems are clearly interdependent elements. Collagenous fibers are interwoven in a plaited structure that closely resembles the osiers of a wicker basket, indicating that collagen fibers allow for lung volume increase up to a point of maximal stretching of the system. The pleural contribution to lung elastic recoil pressure originates from the elastic network which turns back to its resting position when inspiratory pressures are negligible. The pleural immobility in bullous disease is associated with an almost complete absence of elastic fibers and the presence of very thick collagen fibers, suggestive of a cicatricial process, devoid of any characteristic pattern of distribution.

Collagen↗
PubMed1998

A case of giant benign localized fibrous tumor of the pleura.

A 60-year-old man had noted exertional dyspnea and left anterior chest pain. A chest roentgenogram showed the presence of a giant mass and computed tomography (CT) of the chest confirmed the mass with an inhomogeneous density in the left hemithorax. A transthoracic TruCut needle biopsy of the mass showed benign fibrous tissue. The patient underwent a thoracotomy. A tumor arose from the visceral pleura of left lower lobe and pedinculated. Size of the tumor was 19 x 18 x 7 cm and weighed 1500 g. It was successfully resected. The pathological diagnosis of the tumor was benign localized fibrous tumor of the pleura.

Humans↗
PubMed1999

Overdose of tetracycline for pleurodesis leading to chemical burns of the pleura.

Chemical pleurodesis using tetracycline is an accepted and commonly employed treatment of pneumothorax and pleural effusions. We describe a case of chemical burn of the pleura in a ventilated 41-year-old who came to thoracotomy after 3 days of continuous intrapleural infusion of tetracycline at another hospital. To our knowledge this has not been previously reported although other adverse effects of this procedure are documented. We suggest that damage to the pleura and underlying lung may occur if excessive amounts of tetracycline are used in attempted pleurodesis.

Adult↗
PubMed2004

[Thoraxsonography--Part 1: Chest wall and pleura].

The detection of lymph nodes and a careful interpretation of dignity is one of the main indications for chest wall sonography. Palpable unclear masses of the chest wall can undergo US guided puctures very easily. Either rib and sternum fractures are detectable very sensitively. In addition to the more sensitive detection than in normal X-ray also accompanying soft parts processes, pleural effusions and haematomas can be visualised. Despite the physical laws of ultrasound, approximately 70% of the pleural surface can be accessed by sonography. The normal parietal pleural can be visualized and delineated from circumscribed as well as diffuse pathological thickening. The normal visceral pleura is hidden by the total reflection at the surface of the aerated lung. Sonographic evidence of a pleural effusion can be obtained from 5 ml onwards and is much more sensitive than a chest X-ray, especially in supine position; false positive findings are not encountered. A more accurate estimation of the quantity of effusion can be made. Exudates are echogenic in one third of cases. Pleural thickening, nodular changes in the pleura, septa, and the formation of the quality of effusion can be made. Exual exudates, whereas transudates are always anechoic. Pleural metastases are characteristically hypoechoic and nodular-polypoid. Pleural mesotheliomas can be delineated nearly equally well on sonograms and on computed tomography. Morphological and, in particular, functional diagnosis of the diaphragm by means of sonography is both reliable and convincing.

Diagnosis, Differential↗
PubMed1999

[Ultrasound guided forceps biopsy of the pleura].

AIM: Between cytology of pleural effusion and thorascopy there is a gap for another non invasive biopsy method to diagnose pleural diseases, especially since Adam's and Ramel's blind pleural biopsy is uncommon. Therefore it is suggestive to test feasibility and usefulness of pleural forceps biopsy. METHOD: It is possible to take biopsies under ultrasound guidance with the help of a biopsy-forceps from the diaphragmatic pleura or pleural appositions through a 2.5 mm canula with a stop cock and a rubber vent. The specimen can be used for histological or immunohistochemical examinations. The procedure is coducted in a closed system to avoid pneumothorax. The puncture was done in 12 patients with a puncturable pleural effusion. RESULTS: In 11 of 12 patients it was possible to get the final diagnosis. In one of three cases of mesotheliomas a rebiopsy was necessary. In 9 cases a malign tumor was diagnosed, effusion cytology was negative in 4 of 7 tumors. In 5 patients with a history of a former tumor pleural carcinosis was related three times correctly to the former cancer and twice to a secondary cancer. In one case a fibrous plaque was found. There were two patients with pleuritis, in one case a pulmonary tuberculosis was found 8 weeks later. In one patient with a mesothelioma inoculated metastasis were present in the sites of the punctures. In all pleural forceps punctures we got enough biopsy material for histological and immunohistochemical diagnosis. CONCLUSION: The ultrasound guided forceps biopsy of the pleura is a very promising less invasive method to diagnose pleural tumors. Additional improvements of the equipment are possible. Definitive evaluation of the procedure especially in infectious pleural diseases requires a higher number of cases.

Adult↗