-
Respirology (Carlton, Vic.) Jan 2011Pleural malignancies, including primary malignant pleural mesothelioma and secondary pleural metastasis of various tumours resulting in malignant pleural effusion, are... (Review)
Review
Pleural malignancies, including primary malignant pleural mesothelioma and secondary pleural metastasis of various tumours resulting in malignant pleural effusion, are frequent and lethal diseases that deserve devoted translational research efforts for improvements to be introduced to the clinic. This paper highlights select clinical advances that have been accomplished recently and that are based on preclinical research on pleural malignancies. Examples are the establishment of folate antimetabolites in mesothelioma treatment, the use of PET in mesothelioma management and the discovery of mesothelin as a marker of mesothelioma. In addition to established translational advances, this text focuses on recent research findings that are anticipated to impact clinical pleural oncology in the near future. Such progress has been substantial, including the development of a genetic mouse model of mesothelioma and of transplantable models of pleural malignancies in immunocompetent hosts, the deployment of stereological and imaging methods for integral assessment of pleural tumour burden, as well as the discovery of the therapeutic potential of aminobiphosphonates, histone deacetylase inhibitors and ribonucleases against malignant pleural disease. Finally, key obstacles to overcome towards a more rapid advancement of translational research in pleural malignancies are outlined. These include the dissection of cell-autonomous and paracrine pathways of pleural tumour progression, the study of mesothelioma and malignant pleural effusion separately from other tumours at both the clinical and preclinical levels, and the expansion of tissue banks and consortia of clinical research of pleural malignancies.
Topics: Adenocarcinoma; Animals; Antineoplastic Agents; Biomarkers, Tumor; Diphosphonates; Disease Models, Animal; Folic Acid Antagonists; GPI-Linked Proteins; Histone Deacetylase Inhibitors; Humans; Mesothelin; Mesothelioma; Mice; Pleural Effusion; Pleural Neoplasms; Positron-Emission Tomography; Translational Research, Biomedical
PubMed: 21044230
DOI: 10.1111/j.1440-1843.2010.01890.x -
Archives of Pathology & Laboratory... Oct 2012Thoracic manifestations of rheumatic disease (RD) are increasingly recognized as a significant cause of morbidity and mortality worldwide. Rheumatologic underpinnings... (Review)
Review
Thoracic manifestations of rheumatic disease (RD) are increasingly recognized as a significant cause of morbidity and mortality worldwide. Rheumatologic underpinnings have been identified in a significant proportion of patients with interstitial lung disease. The 5 RDs most frequently associated with pleuropulmonary disease are (1) rheumatoid arthritis, (2) systemic lupus erythematosus, (3) progressive systemic sclerosis, (4) polymyositis/dermatomyositis, and (5) Sjögren syndrome. The onset of thoracic involvement in these diseases is variable. In some patients, it precedes the systemic disease or is its only manifestation. Moreover, there is a wide spectrum of clinical presentation ranging from subclinical abnormalities to acute respiratory failure. Histopathologically, the hallmark features of thoracic involvement by RD are inflammatory, targeting one or more lung compartments. The reactions range from acute to chronic, with remodeling by fibrosis being a common result. Although the inflammatory findings are often nonspecific, certain reactions or anatomic distributions may favor one RD over another, and occasionally, a distinctive histopathology may be present (eg, rheumatoid nodules). Three diagnostic dilemmas are encountered in patients with RD who develop diffuse lung disease: 1) opportunistic infection in the immunocompromised host, 2) drug toxicity related to the medications used to treat the systemic disease, and 3) manifestations of the patient's known systemic disease in lung and pleura. To confidently address the latter, the 5 major RDs are presented here, with their most common pleuropulmonary pathologic manifestations, accompanied by brief clinical and radiologic correlations.
Topics: Diagnosis, Differential; Humans; Lung Diseases; Pleural Diseases; Rheumatic Diseases
PubMed: 23020730
DOI: 10.5858/arpa.2012-0248-SA -
The British Journal of Radiology 2016Diagnosis of pleural plaques (PPs) is commonly straightforward, especially when a typical appearance is observed in a context of previous asbestos exposure.... (Review)
Review
Diagnosis of pleural plaques (PPs) is commonly straightforward, especially when a typical appearance is observed in a context of previous asbestos exposure. Nevertheless, numerous causes of focal pleural thickening may be seen in routine practice. They may be related to normal structures, functional pleural thickening, previous tuberculosis, pleural metastasis, silicosis or other rarer conditions. An application of a rigorous technical approach as well as a familiarity with loco-regional anatomy and the knowledge of typical aspects of PP are required. Indeed, false-positive or false-negative results may engender psychological and medico-legal consequences or can delay diagnosis of malignant pleural involvement. Correct recognition of PPs is crucial, as they may also be an independent risk factor for mortality from lung cancer in asbestos-exposed workers particularly in either smokers or former/ex-smokers. Finally, the presence of PP(s) may help in considering asbestosis as a cause of interstitial lung disease predominating in the subpleural area of the lower lobes. The aim of this pictorial essay is to provide a brief reminder of the normal anatomy of the pleura and its surroundings as well as the various aspects of PPs. Afterwards, the common pitfalls encountered in PP diagnosis will be emphasized and practical clues to differentiate actual plaque and pseudoplaque will be concisely described.
Topics: Asbestosis; Humans; Pleura; Pleural Diseases; Tomography, X-Ray Computed
PubMed: 26539633
DOI: 10.1259/bjr.20150792 -
Chest Jul 2023Previous studies have inconsistently reported associations between refractory ceramic fibers (RCFs) or mineral wool fibers (MWFs) and the presence of pleural plaques....
BACKGROUND
Previous studies have inconsistently reported associations between refractory ceramic fibers (RCFs) or mineral wool fibers (MWFs) and the presence of pleural plaques. All these studies were based on chest radiographs, known to be associated with a poor sensitivity for the diagnosis of pleural plaques.
RESEARCH QUESTION
Does the risk of pleural plaques increase with cumulative exposure to RCFs, MWFs, and silica? If the risk does increase, do these dose-response relationships depend on the co-exposure to asbestos or, conversely, are the dose-response relationships for asbestos modified by co-exposure to RCFs, MWFs, and silica?
STUDY DESIGN AND METHODS
Volunteer workers were invited to participate in a CT scan screening program for asbestos-related diseases in France. Asbestos exposure was assessed by industrial hygienists, and exposure to RCFs, MWFs, and silica was determined by using job-exposure matrices. A cumulative exposure index (CEI) was then calculated for each subject and separately for each of the four mineral particle exposures. All available CT scans were submitted to randomized double reading by a panel of radiologists.
RESULTS
In this cohort of 5,457 subjects, significant dose-response relationships were determined after adjustment for asbestos exposure between CEI to RCF or MWF and the risk of PPs (ORs of 1.29 [95% CI, 1.00-1.67] and 1.84 [95% CI, 1.49-2.27] for the highest CEI quartile, respectively). Significant interactions were found between asbestos on one hand and MWF or RCF on the other.
INTERPRETATION
This study suggests the existence of a significant association between exposure to RCFs and MWFs and the presence of pleural plaques in a large population previously exposed to asbestos and screened by using CT scans.
Topics: Humans; Occupational Exposure; Asbestos; Pleural Diseases; Silicon Dioxide
PubMed: 36773934
DOI: 10.1016/j.chest.2023.02.004 -
Tuberkuloz Ve Toraks Mar 2017The most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest- X-Ray findings are the presence of... (Review)
Review
The most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest- X-Ray findings are the presence of pleural effusion and thickening. Small pleural effusions are not readily identified on posteroanterior chest radiograph. However, lateral decubitus chest radiograph and chest ultrasonography may show small pleural effusions. These are more efficient methods than posteroanterior chest radiograph in the erect position for demonstrating small amounts of free pleural effusions. Chest ultrasonograph may be able to help in distinguishing the pleural pathologies from parenchymal lesions. On chest radiograph pleural effusions or pleural thickening may obscure the visibility of the underlying disease or parenchymal abnormality. Thus, computed tomography (CT) may provide additional information of determining the extent and severity of pleural disease and may help to differentiate malign pleural lesions from the benign ones. Moreover, CT may provide the differentiation of parenchmal abnormalities from pleural pathologies. CT (coronal and sagittal reformatted images) that also show invasion of chest wall, mediastinum and diaphragm, as well as enlarged hilar or mediastinal lymph nodes. Standart non-invasive imaging techniques may be supplemented with magnetic resonans imaging (MRI).
Topics: Diaphragm; Humans; Lymph Nodes; Magnetic Resonance Imaging; Mediastinum; Pleura; Pleural Diseases; Pleural Effusion; Radiography, Thoracic; Thoracic Wall; Thorax; Tomography, X-Ray Computed; Ultrasonography
PubMed: 28621248
DOI: 10.5578/tt.47546 -
American Journal of Industrial Medicine Mar 2022Vermiculite ore from Libby, Montana contains on average 24% of a mixture of toxic and carcinogenic amphibole asbestiform fibers. These comprise primarily winchite (84%),...
BACKGROUND
Vermiculite ore from Libby, Montana contains on average 24% of a mixture of toxic and carcinogenic amphibole asbestiform fibers. These comprise primarily winchite (84%), with smaller quantities of richterite (11%) and tremolite (6%), which are together referred to as Libby amphibole (LA).
METHODS
A total of 1883 individuals who were occupationally and/or environmentally exposed to LA and were diagnosed with asbestos-related pleuropulmonary disease (ARPPD) following participation in communitywide screening programs supported by the Agency for Toxic Substances and Disease Registry (ATSDR) and followed up at the Center for Asbestos Related Disease (CARD) between 2000 and 2010. There were 203 deaths of patients with sufficient records and radiographs. Best clinical and radiologic evidence was used to determine the cause of death, which was compared with death certificates.
RESULTS
Asbestos-related mortality was 55% (n = 112) in this series of 203 patients. Of the 203 deaths, 34 (17%) were from asbestos-related malignancy, 75 (37%) were from parenchymal asbestosis, often with pleural fibrosis, and 3 (1.5%) were from respiratory failure secondary to pleural thickening.
CONCLUSIONS
Asbestos is the leading cause of mortality following both occupational and nonoccupational exposure to LA in those with asbestos-related disease.
Topics: Asbestos; Asbestos, Amphibole; Asbestosis; Humans; Montana; Pleural Diseases
PubMed: 34961951
DOI: 10.1002/ajim.23320 -
Thorax May 1972Zinc, copper, and iron were measured in the pleural fluid of 86 patients with benign conditions (including congestive heart failure, pulmonary embolus, collagen disease,...
Zinc, copper, and iron were measured in the pleural fluid of 86 patients with benign conditions (including congestive heart failure, pulmonary embolus, collagen disease, pneumonitis, non-specific pleuritis, and tuberculosis) and in 116 patients with malignant disease (including lymphoma, breast carcinoma, primary lung cancer, and metastatic lung cancer). Though a positive correlation was found between zinc and copper in the benign group and not in the malignant group, the test was not specific enough to differentiate benign from malignant disease, because of the wide scatter of results. A positive regression for serum copper on pleural fluid copper was found in the benign, lymphoma, and malignant groups, but the differences between these three were not sufficient to help in the differential diagnosis. These findings suggest that pleural fluid heavy metals do not have the specificity that has been reported for serum heavy metals in benign and malignant disease and in malignant lymphoma.
Topics: Breast Neoplasms; Collagen Diseases; Copper; Diagnosis, Differential; Heart Failure; Humans; Iron; Lung Neoplasms; Lymphoma; Neoplasm Metastasis; Neoplasms; Pleural Diseases; Pleural Effusion; Pneumonia; Pulmonary Embolism; Zinc
PubMed: 5039453
DOI: 10.1136/thx.27.3.368 -
Jornal Brasileiro de Pneumologia :... 2006This chapter presents a bibliographic review of asbestos-related diseases. The latest diagnostic, radiological, computed tomography and lung function aspects of benign... (Review)
Review
This chapter presents a bibliographic review of asbestos-related diseases. The latest diagnostic, radiological, computed tomography and lung function aspects of benign pleural disease, asbestosis, occupational lung cancer and mesothelioma are discussed.
Topics: Asbestos; Humans; Lung Neoplasms; Mesothelioma; Occupational Diseases; Occupational Exposure; Pleural Diseases; Tomography, X-Ray Computed; Tuberculosis, Pulmonary
PubMed: 17273598
DOI: 10.1590/s1806-37132006000800009 -
Journal of Radiology Case Reports Oct 2013Catamenial pneumothorax is a rare complication secondary to pleural endometriosis. We present a case of a 37-year-old-female with a history of recurrent pneumothoraces... (Review)
Review
Catamenial pneumothorax is a rare complication secondary to pleural endometriosis. We present a case of a 37-year-old-female with a history of recurrent pneumothoraces with an associated temporal relationship to the onset of her menses. In addition to her recurrent pneumothoraces, on further evaluation, she was found to have multiple nodular masses within the omentum. A thoracoscopic biopsy was subsequently performed, which showed endometrial implants within the pleural space and within the omental cavity. The radiological features and pathogenesis of this rare disease are reviewed and discussed with reference to relevant literature.
Topics: Abdominal Pain; Adult; Chest Pain; Cysts; Endometriosis; Female; Humans; Omentum; Pelvis; Peritoneal Diseases; Pleural Diseases; Pneumothorax; Rare Diseases; Recurrence; Tomography, X-Ray Computed
PubMed: 24421917
DOI: 10.3941/jrcr.v7i10.1483 -
Chronic Respiratory Disease Nov 2015This study aimed to measure the levels of physical activity (PA) in people with dust-related pleural and interstitial lung diseases and to compare these levels of PA to... (Observational Study)
Observational Study
This study aimed to measure the levels of physical activity (PA) in people with dust-related pleural and interstitial lung diseases and to compare these levels of PA to a healthy population. There is limited data on PA in this patient population and no previous studies have compared PA in people with dust-related respiratory diseases to a healthy control group. Participants with a diagnosis of a dust-related respiratory disease including asbestosis and asbestos related pleural disease (ARPD) and a healthy age- and gender-matched population wore the SenseWear(®) Pro3 armband for 9 days. Six-minute walk distance, Medical Outcomes Study 36-item short-form health survey and the Hospital Anxiety and Depression Scale were also measured. Fifty participants were recruited and 46 completed the study; 22 with ARPD, 10 with dust-related interstitial lung disease (ILD) and 14 healthy age-matched participants. The mean (standard deviation) steps/day were 6097 (1939) steps/day for dust-related ILD, 9150 (3392) steps/day for ARPD and 10,630 (3465) steps/day for healthy participants. Compared with the healthy participants, dust-related ILD participants were significantly less active as measured by steps/day ((mean difference 4533 steps/day (95% confidence interval (CI): 1888-7178)) and energy expenditure, ((mean difference 512 calories (95% CI: 196-827)) and spent significantly less time engaging in moderate, vigorous or very vigorous activities (i.e. >3 metabolic equivalents; mean difference 1.2 hours/day (95% CI: 0.4-2.0)). There were no differences in levels of PA between healthy participants and those with ARPD. PA was reduced in people with dust-related ILD but not those with ARPD when compared with healthy age and gender-matched individuals.
Topics: Accelerometry; Aged; Aged, 80 and over; Anxiety; Asbestos; Asbestosis; Case-Control Studies; Depression; Exercise Test; Exercise Tolerance; Forced Expiratory Volume; Health Status; Humans; Lung Diseases, Interstitial; Male; Middle Aged; Motor Activity; New South Wales; Occupational Exposure; Pleural Diseases; Prospective Studies; Quality of Life; Silicon Dioxide; Silicosis; Surveys and Questionnaires
PubMed: 26048393
DOI: 10.1177/1479972315587518