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Thorax Sep 1981During a 10-year period (1970-79) all patients in Uppsala County found to have pleural changes related to asbestos exposure were followed. The lesions could be divided...
During a 10-year period (1970-79) all patients in Uppsala County found to have pleural changes related to asbestos exposure were followed. The lesions could be divided into four types: parietal pleural plaques, exudative pleurisy, thickening of the visceral pleura, and progressive pleural fibrosis. There were 891 cases. The most common type was parietal plaques, which was seen in 827 patients, some of whom later developed other changes. In 22 types exudation was proven radiologically, and in 84 more cases obliteration of the costo-phrenic angle was seen. The exudations almost all had a benign course, despite sometimes fairly large and bloody effusions. They were practically all symptom-free, being a surprise finding on chest radiography. Thickening of the visceral pleura can only be seen radiologically in the fissures and occurred in a few cases in addition to other changes. In a small group of more heavily exposed individuals, a progressive pleural fibrosis developed, sometimes after an initial effusion.
Topics: Adult; Asbestosis; Female; Follow-Up Studies; Humans; Male; Pleura; Pleural Diseases; Pleural Effusion; Radiography; Sweden
PubMed: 7314042
DOI: 10.1136/thx.36.9.669 -
Cell and Tissue Research Feb 2011Information about the ultrastructure of connective (interstitial) cells supporting the pleural mesothelium is scarce. Our aim has been to examine whether telocytes (TCs)...
Information about the ultrastructure of connective (interstitial) cells supporting the pleural mesothelium is scarce. Our aim has been to examine whether telocytes (TCs) are present in pleura, as in epicardium and mesentery. TCs are a distinct type of cell, characterized by specific prolongations named telopodes (Tp). We have used transmission electron microscopy (TEM) and electron tomography (ET) to determine whether ultrastructural diagnostic criteria accepted for TCs are fulfilled by any of the cell subpopulations existing in the sub-mesothelial layer in mouse and human pleura. TCs have been identified with TEM by their characteristic prolongations. Tp appear long and moniliform, because of the alternation of podomeres (thin segments of less than 0.2 μm) and podoms (small dilations accommodating caveolae, mitochondria, and endoplasmic reticulum). Tp ramifications follow a dichotomic pattern and establish specialized cell-to-cell junctional complexes. TCs, via their Tp, seem to form an interstitial network beneath the mesothelium, covering about two-thirds of the abluminal mesothelial layer. ET has revealed complex junctional structures and tight junctions connecting pleural TCs, and small vesicles at this level in Tp. Thus, pleural TCs share significant similarities with TCs described in other serosae. Whether TCs are a (major) player in mesothelial-cell-induced tissue repair remains to be established. Nevertheless, the extremely long thin Tp and complex junctional structures that they form and the release of vesicles (or exosomes) indicate the participation of TCs in long-distance homo- or heterocellular communication.
Topics: Animals; Cells, Cultured; Epithelium; Humans; Imaging, Three-Dimensional; Mice; Microscopy, Electron, Transmission; Pleura
PubMed: 21174125
DOI: 10.1007/s00441-010-1095-0 -
The Journal of Thoracic and... Jul 2005Although visceral pleural invasion by non-small cell lung cancer is considered a poor-prognostic factor, further information is lacking, especially in relation to other...
OBJECTIVE
Although visceral pleural invasion by non-small cell lung cancer is considered a poor-prognostic factor, further information is lacking, especially in relation to other clinicopathologic prognostic factors. We assessed the relationship between visceral pleural invasion and other clinicopathologic characteristics and evaluated its significance as a prognostic factor.
METHODS
We reviewed 1074 patients with surgically resected T1/2 non-small cell lung cancer for their clinicopathologic characteristics and prognoses. The patients were divided into 2 groups according to visceral pleural invasion status (visceral pleural invasion group and non-visceral pleural invasion group). Both groups were compared with regard to age, sex, histology, tumor size, tumor differentiation, lymph node involvement, lymphatic invasion, vascular invasion, scar grade, nuclear atypia, mitotic index, serum carcinoembryonic antigen level, and survival. Univariate and multivariate analyses were conducted.
RESULTS
Visceral pleural invasion was identified in 288 (26.8%) of the resected specimens. Survival was 76.0% at 5 years and 53.2% at 10 years in the non-visceral pleural invasion group and was 49.8% at 5 years and 37.0% at 10 years in the visceral pleural invasion group. The difference between groups was highly significant ( P < .0001). Visceral pleural invasion was also significantly associated with a higher frequency of lymph node involvement. However, regardless of N status (N0 or N1/2), there was a significant difference in survival when the visceral pleura was invaded. Visceral pleural invasion was observed significantly more frequently in tumors with factors indicative of tumor aggressiveness/invasiveness: moderate/poor differentiation, lymphatic invasion, vascular invasion, high scar grade, high nuclear atypia grade, high mitotic index, and high serum carcinoembryonic antigen level. By multivariate analysis, visceral pleural invasion proved to be a significant independent predictor of poor prognosis in non-small-cell lung cancer patients with or without lymph node involvement.
CONCLUSIONS
Visceral pleural invasion is a significant poor-prognostic factor, regardless of N status. Our analyses indicated that visceral pleural invasion is an independent indicator of non-small cell lung cancer invasiveness and aggressiveness.
Topics: Aged; Carcinoembryonic Antigen; Carcinoma, Non-Small-Cell Lung; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Mitotic Index; Multivariate Analysis; Neoplasm Invasiveness; Pleura; Prognosis
PubMed: 15999057
DOI: 10.1016/j.jtcvs.2004.11.021 -
Zhongguo Fei Ai Za Zhi = Chinese... Sep 2018Intraoperative pleural lavage cytology is a diagnostic technique used to detect tumor cells and serve as a prognostic parameter for non-small cell lung cancer (NSCLC)... (Review)
Review
Intraoperative pleural lavage cytology is a diagnostic technique used to detect tumor cells and serve as a prognostic parameter for non-small cell lung cancer (NSCLC) patients. In the past several decades, many scholars have been dedicated to clarifying the relationships between positive intraoperative pleural lavage cytology results and postoperative survival as well as tumor recurrence and metastasis. However, the findings remained various due to the inhomogeneity of different research. It has been confirmed that a positive intraoperative pleural lavage cytology result is one of the risk factors for the prognosis of postoperative patients. This study reviewed the advances in research of intraoperative pleural lavage cytology in recent years from several aspects, including clinical significance, influencing factors and possible mechanisms. .
Topics: Cytological Techniques; Humans; Intraoperative Period; Lung Neoplasms; Pleura
PubMed: 30201073
DOI: 10.3779/j.issn.1009-3419.2018.09.12 -
Journal of the Royal Society of Medicine Nov 1989
Topics: Bile; Diaphragm; Humans; Male; Middle Aged; Pleura; Pleural Effusion; Radiography
PubMed: 2593124
DOI: 10.1177/014107688908201121 -
Monaldi Archives For Chest Disease =... Apr 2021Idiopathic pleuropulmonary fibroelastosis is an extremely rare lung disease characterized by the combination of fibrosis of the visceral pleura and the fibroelastotic...
Idiopathic pleuropulmonary fibroelastosis is an extremely rare lung disease characterized by the combination of fibrosis of the visceral pleura and the fibroelastotic changes transcending in the subpleural lung parenchyma that predominantly affects the upper lobes with accompanying volume loss. It is mostly idiopathic while infection, autoimmunity, bone marrow or lung transplantation and genetic predisposition may be associated with the development of PPFE. The disease is exceptionally rare as approximately ninety cases have been reported in the literature currently. A 35-year-old female presented with exertional dyspnea, dry cough and weight loss. Physical examination demonstrated platythorax, suprasternal notch deepening and fine rales over the upper lobes. Blood count, serum biochemistry, autoimmunity and serologic markers for collagen vascular diseases were within normal limits. Arterial blood gases demonstrated a low pO2 (48 mm Hg) and a high pCO2 (54 mm Hg) values. Chest x-ray showed bilateral parenchymal fibrotic lesions, left pneumothorax, bronchiectasis in the middle and pleural thickening in the upper lung zones while HRCT revealed bilateral apical pleural thickening, traction bronchiectasis, subpleural reticulations, ground-glass opacities and honeycombing in the upper lobes. Bronchoscopy, BAL cytology, smear and culture did not reveal any pathologic findings. Relevant with the clinical, laboratory, radiologic manifestations and the differential diagnosis with other interstitial lung diseases, PPFE was the final diagnosis. The aim of this case report was to present the clinical manifestations of our case. The second crucial objective was to establish a diagnostic scoring system relevant with the literature and the clinical manifestations of the patient.
Topics: Adult; Female; Humans; Lung; Lung Diseases, Interstitial; Lung Transplantation; Pleura; Pleural Diseases
PubMed: 33840184
DOI: 10.4081/monaldi.2021.1713 -
Medicina (Kaunas, Lithuania) Oct 2020: The larvae of Echinococcus, a parasitic tapeworm, cause hydatid disease. The most commonly involved organ after the liver is the lung but there are cases of hydatid... (Review)
Review
: The larvae of Echinococcus, a parasitic tapeworm, cause hydatid disease. The most commonly involved organ after the liver is the lung but there are cases of hydatid cysts in all systems and organs, such as brain, muscle tissue, adrenal glands, mediastinum and pleural cavity. Extra-pulmonary intrathoracic hydatidosis can be a diagnostic challenge and a plain chest x-ray can be misleading. It can also lead to severe complications such as anaphylactic shock or tension pneumothorax. The purpose of this paper is to present a severe case of primary pleural hydatidosis, as well as discussing the difficulties that come with it during diagnosis and treatment. We present the case of a 43-year-old male, working as a shepherd, presenting with moderate dyspnea, chest pain and weight loss. Chest x-ray revealed an uncharacteristic massive right pleural effusion and thoracic computed tomography (CT) confirmed it, as well as revealing multiple cystic formations of various sizes and liquid density within the pleural fluid. Blood work confirmed our suspicion of pleural hydatidosis with an elevated eosinophil count, typical in parasite diseases. Surgery was performed by right lateral thoracotomy and consisted of removal of the hydatid fluid and cysts found in the pleura. Patient was discharged 13 days postoperative with Albendazole treatment. Cases of primary pleural hydatidosis are very rare but must be taken into consideration in patients from endemic regions with jobs that may have exposure to this parasite. Proper treatment, both surgical and antiparasitic medication, can lead to a full recovery and a low chance of recurrent disease.
Topics: Adult; Albendazole; Echinococcosis, Pulmonary; Humans; Male; Pleura; Radiography; Tomography, X-Ray Computed
PubMed: 33121083
DOI: 10.3390/medicina56110567 -
Journal of Medicine and Life 2015Up to the middle of the last century, the thoracic spine, especially in its upper part, has been considered an unapproachable site, a no-man's land, but the constant... (Review)
Review
BACKGROUND
Up to the middle of the last century, the thoracic spine, especially in its upper part, has been considered an unapproachable site, a no-man's land, but the constant evolution of medicine imposed techniques of the spine at these levels in order to solve a large area of pathology (infectious, tumoral, traumatic, and last but not least, deformative). This way, a series of anterior approaches allowed surgeons to gain access to the anterior part of the spine and the posterior mediastinum. The approaches described by Hodgson, Mirbaha or transthoracic transpleural approach (T4-T11), are enumerated. The idea to allow a more visible and extensive approach, but to avoid respiratory issues due to the lesion of the pleura, led to the description of a new anterior approach by Burnei in 2000.
MATERIAL AND METHOD
Burnei's approach represents an anterior approach to the thoracic spine, being a transthoracic and retropleural one. This approach allows a large area of spinal pathology due to infectious, traumatic, tumoral and degenerative (idiopathic or congenital scoliosis) causes. Statistically, this approach has been performed more frequently in cases of spinal instrumentation after diskectomy, in order to perform a partial correction of severe, rigid idiopathic scoliosis with more than 70 degrees Cobb and in cases of congenital scoliosis for hemivertebra resection and somatic synthesis to correct the scoliotic curve.
RESULTS
This kind of anterior approach allows the surgeon a large visibility of the anterior thoracic spine, diskectomies of up to 5 levels to tender the curve of the deformity and to ensure somatic or/ and transpedicular synthesis of up to 6 thoracic vertebrae. By performing a thoracotomy involving the resection of the posterior arches of the ribs, a thoracoplasty is also ensured with functional and aesthetic effects, by ameliorating the thoracic hump due to the scoliotic deformity.
CONCLUSIONS
Burnei's approach joins all the other anterior approaches of the spine, addressing a large area of pathology of the thoracic spine. Even if difficult to be performed, requiring a thorough and perfect technique in the hands of a skilled surgeon, it will ensure satisfaction due to the detailed and visible exposure of the thoracic spine.
Topics: Brunei; Humans; Pleura; Plastic Surgery Procedures; Scoliosis; Spinal Cord Diseases; Thoracic Vertebrae
PubMed: 25866572
DOI: No ID Found -
The Journal of Physiological Sciences :... Jul 2009The effect of dexamethasone on the transmesothelial electrical resistance (R(TM)) of sheep pleura was investigated by Ussing chamber experiments. Our results show that...
The effect of dexamethasone on the transmesothelial electrical resistance (R(TM)) of sheep pleura was investigated by Ussing chamber experiments. Our results show that dexamethasone decreases the R(TM) of sheep pleurae, in part by stimulation of glucocorticoid receptors. This finding may be of importance in regard to the faster resolution of corticosteroid-treated pleural effusions.
Topics: Animals; Dexamethasone; Electric Impedance; Epithelium; Female; Glucocorticoids; In Vitro Techniques; Male; Pleura; Pleural Effusion; Receptors, Glucocorticoid; Sheep
PubMed: 19462220
DOI: 10.1007/s12576-009-0042-x -
Lung Cancer (Amsterdam, Netherlands) Apr 2019Mesothelioma patients rely on the information their clinical team obtains from medical imaging. Whether x-ray-based computed tomography (CT) or magnetic resonance... (Review)
Review
Mesothelioma patients rely on the information their clinical team obtains from medical imaging. Whether x-ray-based computed tomography (CT) or magnetic resonance imaging (MRI) based on local magnetic fields within a patient's tissues, different modalities generate images with uniquely different appearances and information content due to the physical differences of the image-acquisition process. Researchers are developing sophisticated ways to extract a greater amount of the information contained within these images. This paper summarizes the imaging-based research presented orally at the 2018 International Conference of the International Mesothelioma Interest Group (iMig) in Ottawa, Ontario, Canada, held May 2-5, 2018. Presented topics included advances in the imaging of preclinical mesothelioma models to inform clinical therapeutic strategies, optimization of the time delay between contrast administration and image acquisition for maximized enhancement of mesothelioma tumor on CT, an investigation of image-based criteria for clinical tumor and nodal staging of mesothelioma by contrast-enhanced CT, an investigation of methods for the extraction of mesothelioma tumor volume from MRI and the association of volume with patient survival, the use of deep learning for mesothelioma tumor segmentation in CT, and an evaluation of CT-based radiomics for the prognosis of mesothelioma patient survival.
Topics: Congresses as Topic; Diagnostic Imaging; Humans; International Cooperation; Magnetic Resonance Imaging; Mesothelioma; Phantoms, Imaging; Pleura; Pleural Neoplasms; Prognosis; Public Opinion; Tomography, X-Ray Computed
PubMed: 30885330
DOI: 10.1016/j.lungcan.2018.11.033