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At least 19 recordsLinked to original sources
PubMed1996

Calcifying fibrous pseudotumor of pleura. A report of three cases of a newly described entity involving the pleura.

A newly recognized distinctive fibrous soft tissue lesion called "calcifying fibrous pseudotumor" (CFPT) was recently described in the soft tissues of the extremities, trunk, scrotum, groin, neck, or axilla. To date, CFPT has not been described in the pleura. The authors reviewed the clinical, radiologic, and pathologic features of three cases. A 23-year old woman and 34-year old man who presented with chest pain, and a 28-year old woman without chest symptoms were found to have a pleural mass on chest radiographs. Computed tomography (CT) scans of each patient revealed pleural-based nodular masses with central areas of increased attenuation due to calcifications. Each lesions consisted of circumscribed, but unencapsulated masses of hyalinized collagenous fibrotic tissue interspersed with lymphoplasmacytic infiltrates and calcifications, many of which had psammomatous features. The lesions were limited to the pleura and did not involve the underlying lung parenchyma. Electron microscopy in one case showed fibroblasts scattered in dense collagenous tissue. Calcifying fibrous pseudotumor is distinct from other pleural lesions such as fibrous tumor of pleura, calcified granulomas, calcified pleural plaques, and chronic fibrous pleuritis as well as intrapulmonary lesions such as hyalinizing granuloma, inflammatory pseudotumor, and amyloid. As in the soft tissues, local excision appears adequate therapy for CFPT of the pleura. If these lesions behave in a similar fashion to CFPT of soft tissues, one might expect a low frequency of local recurrence.

Adult↗
PubMed1983

The pleura: a combined light microscopic, scanning, and transmission electron microscopic study in the sheep. I. Normal pleura.

The structural features of the ovine pleura are described using light, scanning, and transmission electron microscopy. Extensive sampling of the visceral and parietal pleura revealed considerable variation in both surface morphology and pleural interstitial anatomy. Variations of mesothelial surface were encountered and these were due to microvillar density and length. The pleural interstitium varied considerably in thickness, being relatively sparse in the anterior lung lobes, where respiratory excursion is least, and much more robust in the caudal lung lobes, where respiratory excursion is greatest. A similar correlation was observed with regard to the abundance and extent of the elastic meshwork embedded in the interstitium. The parietal pleura had openings which connected directly with the lymphatics in the underlying interstitium, thus forming a direct channel between the pleural cavity and the lymphatic system.

Animals↗
PubMed2001

Effects of SNP, ouabain, and amiloride on electrical potential profile of isolated sheep pleura.

The fluid and solute transport properties of pleural tissue were studied by using specimens of intact visceral and parietal pleura from adult sheep lungs. The samples were transferred to the laboratory in a Krebs-Ringer solution at 4 degrees C within 1 h from the death of the animal. The pleura was then mounted as a planar sheet in a Ussing-type chamber. The results that are presented in this study are the means of six different experiments. The spontaneous potential difference and the inhibitory effects of sodium nitroprusside (SNP), ouabain, and amiloride on transepithelial electrical resistance (R(TE)) were measured. The spontaneous potential difference across parietal pleura was 0.5 +/- 0.1 mV, whereas that across visceral pleura was 0.4 +/- 0.1 mV. R(TE) of both pleura was very low: 22.02 +/- 4.1 Omega. cm2 for visceral pleura and 22.02 +/- 3.5 Omega. cm2 for parietal pleura. There was an increase in the R(TE) when SNP was added to the serosal bathing solution of parietal pleura and to the serosal or mucosal bathing solution in visceral pleura. The same was observed when ouabain was added to the mucosal surface of visceral pleura and to either the mucosal or serosal surface of parietal pleura. Furthermore, there was an increase in R(TE) when amiloride was added to the serosal bathing solution of parietal pleura. Consequently, the sheep pleura appears to play a role in the fluid and solute transport between the pleural capillaries and the pleural space. There results suggest that there is a Na+ and K+ transport across both the visceral and parietal pleura.

Amiloride↗
PubMed2002

Effect of amiloride in human and sheep parietal pleura.

The fluid and solute transport properties of human parietal pleura were studied and compared with sheep parietal pleura in vitro. The pleura was mounted as a planar sheet between Ussing-type chambers. The results presented are the mean values of nine different experiments. The transepithelial electrical resistance (R(TE)) of both pleurae species was measured before and after the addition of amiloride in both sides of pleura. The R(TE) for human was 25.74 +/- 1.23 Ohm x cm(2), while for the sheep it was 38.18 +/- 0.83 Ohm x cm(2). The addition of amiloride to the serosal bathing solution increased the R(TE) of human pleura to 30.48 +/- 1.01 Ohm x cm(2) and sheep pleura to 40.32 +/- 0.82 Ohm x cm(2), while amiloride had no effect on the basolateral side. From the above, it is strongly suggested that the human pleura seems to be more leaky than sheep pleura. Although the R(TE) was increased in both pleurae, the elevation in human pleura was significantly higher, thus results from experiments in sheep pleura could only partly be extrapolated in human pleura.

Amiloride↗
PubMed1995

[An experimental model of pleural adenocarcinoma constructed by the implantation of intact human neoplastic tissue in the nude mouse. The prognostic value of a lesion of the visceral pleura].

In certain cases pleural adenocarcinoma can behave like a primary tumour of the pleura. If the origin of this type of tumour is not clearly established, the macroscopic aspect of the pleura explored by thoracoscopy enables a distinction to be made between isolated disease of the parietal pleura and mixed disease of both the parietal and visceral pleura. The object of this study was to evaluate the prognosis of tumour disease of the visceral pleura. Using a murine model (the nude mouse) of cancer of both visceral and parietal pleura induced by implanting histologically intact human carcinoma, we have compared the symptoms of survival of the two groups of mice as well as the local and regional dissemination and metastases of the implanted tumour. The growth of the tumour was suspected by the appearance of weight loss, signs of respiratory difficulty and/or cachexia. Autopsy examination allowed a measure of the size of tumour dissemination. A pleural cancer, histologically identical to the initial human tumour with invasion of the neighbouring structures as one sees in man, was obtained in all the implants. Nevertheless, contralateral mediastinal lymph node metastases were only found in mice with implants on the visceral pleura. The median survival was 27.9 days and 31 days respectively for implanted mice on the visceral pleura and on the parietal pleura. Mice with implants on the visceral pleural lost more weight than those implanted on the parietal pleura (p < 0.001). The results of this study show that the models of parietal pleura and visceral pleura each correspond to an early stage disease and to a stage of advanced disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

Energy-dispersive X-ray analysis and scanning electron microscopy of pleura. Study of reference, exposed non-pneumoconiotic, and silicotic populations.

Inorganic element content in pleura and lung was studied by energy-dispersive X-ray analysis (EDXA) and scanning electron microscopy (SEM) in reference, exposed non-pneumoconiotic, and silicotic populations. Samples of parietal pleura, visceral pleura, and lung in 11 subjects with no measurable exposure to inorganic dust and of visceral pleura and lung samples of 10 exposed non-pneumoconiotic individuals and eight silicotic patients were examined. Constant depositions of silicon and calcium were detected in visceral pleura, parietal pleura, and lung of the reference group and in visceral pleura and lung of the exposed non-pneumoconiotic and silicotic groups. Other elements, such as aluminum and iron, were also detected in the exposed non-pneumoconiotic and silicotic patients and, less frequently, in the reference group. There was no difference in silicon content between parietal and visceral pleura in the reference group. Silicon content in silicotic patients was higher and more irregularly distributed in the pleura (p = 0.005 and p < 0.01, respectively) and in the lung (p = 0.005 and p < 0.01, respectively) than in the reference group. Comparison of the silicon content in pleura between silicotic and exposed non-pneumoconiotic subjects showed a nonsignificant probability of difference (p = 0.052), whereas there were no differences with respect to the silicon content in lung. There were no differences in the pleural and lung silicon content between the exposed non-pneumoconiotic and reference groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2003

Prognostic value of visceral pleura invasion in non-small cell lung cancer.

OBJECTIVES: The purpose of this study was to clarify the prognostic significance of visceral pleura invasion in T2 non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Between 1990 and 2001, 439 consecutive patients with T2 NSCLC underwent curative surgical resection. The subjects included 234 patients with stage IB, 95 with stage IIB, and 110 with stage IIIA and B disease. The patients were divided into two groups according to the existence of visceral pleura invasion (group I without, group II with). Both groups were compared with regard to tumor size, histology, associated mediastinal lymph node involvement, and survival rates. RESULTS: Visceral pleura invasion (group II) was identified in 114 patients (26%), and was present in 22% of patients with NSCLC with a tumor size of 3 cm or less and in 27% of those with a tumor larger than 3 cm (P=0.37). Visceral pleura invasion was associated with a higher frequency of mediastinal lymph node involvement (group I=22%, group II=34%, P=0.009). Five- and 10-year survival rates were 50 and 45% in group I, and 36 and 22% in group II (P=0.0006). In stage IB, visceral pleura invasion was identified in 53 patients (23%), and 5- and 10-year survival rates were 63 and 60% in the visceral pleura non-invasion group, and 44 and 28% in visceral pleura invasion group (P=0.0018). By multivariate Cox model analysis, age at intervention (relative risk=1.03, P=0.0017), N status (relative risk=1.53, P<0.0001), tumor size (relative risk=1.83, P=0.0452) and visceral pleura invasion (relative risk=1.42, P=0.0291) were independent predictors of poor prognosis. CONCLUSIONS: We were able to demonstrate that visceral pleura invasion was a factor of poor prognosis in T2 NSCLC. It was found to correlate with more extensive mediastinal lymph node involvement and a decreased survival rates. Therefore, the patients with visceral pleura invasion should be closely followed up especially.

Adolescent↗
PubMed2002

Rapid effects of 17beta-estradiol and progesterone on sheep visceral and parietal pleurae via a nitric oxide pathway.

We investigated the effects of 17beta-estradiol and progesterone on transepithelial electrical resistance (R(TE)) in sheep visceral and parietal pleurae. Specimens of intact pleurae from adult female sheep were used. The samples were transferred to the laboratory within 30 min after death of the animal in a Krebs-Ringer solution at 4 degrees C. The pleura was then mounted as a planar sheet in Ussing-type chambers, and electrical measurements were made. There was an increase in R(TE) in all of the samples examined after addition of 17beta-estradiol and progesterone in visceral and parietal pleurae. This increase was rapid within 1 min, lasted for ~15 min, returned to the basal level within 30-45 min, and was dose dependent. Tamoxifen, an estrogen receptor antagonist, did not significantly eliminate the effect of 17beta-estradiol. Furthermore, no steroid receptors were identified in cytosolic preparations of visceral and parietal pleura with ligand binding assays. The estrogen- and progesterone-induced increase in R(TE) in both visceral and parietal pleurae was affected by addition of an inhibitor of nitric oxide synthase. Indeed, previous administration of N(omega)-nitro-L-arginine methyl ester prevented the increase in R(TE) by 17beta-estradiol and progesterone. These results suggest that 17beta-estradiol and progesterone induce an increase in R(TE) in both visceral and parietal pleura and thus alter the transepithelial permeability. The effect of steroids may be accounted for by rapid release of nitric oxide in pleura.

Animals↗
PubMed1998

Invasion beyond interlobar pleura in non-small cell lung cancer.

STUDY OBJECTIVE: To assess the outcome of lung cancer with invasion beyond interlobar pleura and to clarify whether it should be treated in the same way as invasion to the parietal pleura or to other visceral pleura. DESIGN: Retrospective analysis. SETTING: Tokyo Medical College Hospital. PATIENTS: Eighteen resected non-small cell lung cancers with invasion beyond interlobar pleura were studied. The outcomes of those patients, those with parietal pleural invasion, and those with other visceral pleural invasion were compared. Patients with rib invasion, mediastinal organ invasion, or distant metastasis were excluded. RESULTS: The 5-year survival rate for patients with invasion beyond interlobar pleura was 34.2% and the median survival time was 56.5 months. The outcome was significantly better than that of patients with parietal pleural invasion. There was no significant difference between the outcome of invasion beyond interlobar pleura and that of other visceral pleural invasion. In patients without lymph node metastasis, similar results were obtained. There was no difference between the outcome of patients with invasion beyond interlobar pleura, who undergo lobectomy with a parietal resection of the invaded lobe, and that of patients with visceral pleural invasion, who undergo lobectomy. CONCLUSIONS: The behavior of patients with invasion beyond interlobar pleura is different from that of patients with parietal pleural invasion and should be categorized as T2. The optimum operative method was lobectomy with only parietal resection of the invaded lobe to preserve the pulmonary function.

Aged↗
PubMed1978

Differences in normal structure and reaction to adjuvant between the costal and the visceral pleura.

Visceral and costal pleurae of the rabbit were studied by light and electron microscopy in the normal state, after India ink injection into the pleural cavity and in pleuritis induced by intrapleurally injected adjuvant. In normal rabbits, the mesothelial cells in the visceral pleura had more numerous microvilli and pinocytotic vesicles than in the costal pleura. The surface coat on the microvilli was much thicker in the former than in the latter. Intrapleurally injected India ink particles were phagocytosed by mesothelial cells and macrophages. The phagocytotic activity was more prominent on the costal side than on the visceral side. In rabbits with adjuvant induced pleuritis, the visceral pleura, but not the costal pleura, showed mushroom-like projections on the pleural surface which were composed of a fibrin mass mixed with phagocytotic macrophages and covered by proliferative mesothelial cells. These hitherto poorly known structures, which were formed, though less conspicuously, also after India ink administration, seemed to play an important role in the initial protection of the lung against foreign body invasions from the pleural cavity. With the progress of pleuritis, the mushroom-like projections changed into patchy granulation tissues which were well localized and did not exceed the elastic layer. In the costal pleura, apparently due to a poorer protective mechanism than in the visceral pleura, granulation tissue was formed much more extensively and diffusely. No signs of transformation of mesothelial cells into fibroblasts were recognized. Fat-containing cells closely resembling the Ito cells in the liver occurred in the submesothelial and subpleural layers of the visceral pleura.

Acid Phosphatase↗
PubMedDate not supplied

Respiratory mechanics in the open chest: effects of parietal pleurae.

To understand how the parietal pleurae affect the mechanical behavior of the human respiratory system after the chest wall is opened by median sternotomy, we studied 18 anesthetized/paralyzed patients immediately before coronary artery bypass grafting surgery. Elastances and resistances of the total respiratory system (ETr, Rrs) were calculated from measurements of airway pressure and flow during mechanical ventilation in the frequency and tidal volume ranges of normal breathing. Elastances and resistances of the lungs (EL, RL), chest wall (Ecw, Rcw) were also estimated from measurements of esophageal pressure. Data were collected in the closed chest, after median sternotomy with the parietal pleurae intact and after the left parietal pleura was opened for internal mammary artery harvest. After sternotomy with pleurae intact (n = 14), Ers did not change but Rrs decreased (p < 0.05). Ecw (including the contribution of the pleurae) was higher than in the closed chest (p < 0.05) while EL and RL were lower (p < 0.05); Rcw did not change. Opening the left pleura (n = 10) decreased Ers (p < 0.05), but Rrs did not change. We conclude that the chest wall/pleurae compartment offers significant impedance to lung expansion after sternotomy and rib retraction, unless one pleura is opened.

Adult↗
PubMed1988

Comparative permeability of canine visceral and parietal pleura.

To determine the permeability of canine pleural mesothelium, visceral and intercostal parietal pleura from mongrel dogs was carefully stripped from the underlying tissue and mounted as a planar sheet in a Ussing-type chamber. The hydraulic conductivity (Lp) was determined from the rate of volume flux in response to hydrostatic pressure gradients applied to either the mucosal or serosal surface of the pleural membrane. The diffusional permeability (Pd) of radiolabeled water, sucrose, inulin, and albumin was determined under equilibrium conditions from the unidirectional tracer flux. The Lp of the visceral pleura was 0.39 +/- 0.032 (SE) X 10(-4) ml.s-1.cmH2O-1.cm-2 and that Lp of parietal pleura was 1.93 +/- 0.93 X 10(-4) ml.s-1.cmH2O-1.cm-2 (P less than 0.001). The Pd of the visceral pleura ranged from 12.21 +/- 0.45 X 10(-4) cm/s for 3H2O to 0.34 +/- 0.03 X 10(-4) cm/s for [3H]albumin. The Pd of the parietal pleura for water and sucrose was similar to that of the visceral membrane, whereas its Pd for the larger inulin and albumin molecules was greater than that of visceral pleura (P less than 0.01). A spontaneous potential difference could not be detected across either membrane. The relatively higher parietal pleural Lp and Pd for larger solutes is probably due to the presence of stomata in this membrane. These results indicate that both the parietal and the visceral pleura are extremely permeable tissues which offer little resistance to water and solute flux.

Albumins↗
PubMed1996

Black spots concentrate oncogenic asbestos fibers in the parietal pleura. Thoracoscopic and mineralogic study.

Epidemiologic and pathologic data demonstrate that malignant mesothelioma occurs preferentially after exposure to long amphibole asbestos fibers. However, mineralogic studies have rarely detected such fibers in the parietal pleura. We hypothesized that the distribution of asbestos fibers in the pleura was heterogeneous and that they might concentrate in certain areas, as does coal dust in patients showing anthracotic "black spots" of the parietal pleura during thoracoscopy. We collected thoracoscopic biopsy samples from these black spots and from normal areas of the parietal pleura and lung from 14 subjects (eight with and six without asbestos exposure). Asbestos content was determined by transmission electron microscopy. In exposed subjects, mean fiber concentrations were 12.4 +/- 9.8 x 10(6) fibers/g of dry tissue in lung, 4.1 +/- 1.9 in black spots, and 0.5 +/- 0.2 in normal pleura. In unexposed patients, concentrations were 0, 0.3 +/- 0.1, and 0, respectively. Amphiboles outnumbered chrysotile in all samples. A total of 22.5% of fibers were > or = 5 microns in length in black spots. A histologic similarity of these black spots with milky spots is suggested by conventional and electron microscopy. We conclude that the distribution of asbestos fibers is heterogeneous in the parietal pleura. Indeed, the fibers concentrate in black spots, where they can reach high concentrations. These findings could explain why the parietal pleura is the target organ for mesothelioma and plaques.

Adenocarcinoma↗
PubMed1999

Clinical behavior of solitary fibrous tumors of the pleura.

BACKGROUND: Solitary fibrous tumors of the pleura are rare and present unpredictable clinical behavior. METHODS: Between 1981 and 1998, 11 solitary fibrous tumors of the pleura were resected in 10 patients at the University Hospital of Geneva. Their clinical behavior and outcome were reviewed. RESULTS: Seven tumors arose from the visceral pleura, and three arose from the parietal pleura. Tumors arising from the parietal pleura were revealed to be more difficult to resect than those from the visceral pleura because of their size and adhesion to the chest wall requiring extrapleural resection. Eight tumors showed benign features, whereas two showed distinct features of malignity. One additional patient presented marked pleomorphism that could represent an intermediate form before frank malignity. Four tumors had been followed expectantly for 2 to 10 years before surgery. Although three enlarged rapidly, no signs of malignity were observed on histological examination. All patients are alive, from 2 months to 14 years after surgery (mean 55 months). In one case, however, a malignant tumor recurred 6 years after resection of a benign variant. CONCLUSIONS: Although histologically benign, solitary fibrous tumors of the pleura may enlarge rapidly and occasionally transform into malignant variants after several years. Therefore, complete surgical resection and long-term follow-up is recommended for all patients.

Adult↗
PubMed1997

Contacting metastasis of a fibrous tumor of the pleura.

A 26-year-old female with a fibrous tumor of the pleura that metastasized to the other site of the pleura due to contact is reported. The primary lesion was a 6-cm pedunculated tumor originating from the diaphragm; the metastasis was a broad-based 1-cm tumor located on the parietal pleura of the lateral thoracic wall, within an area in contact with the primary tumor. The surrounding pleura around the small tumor and the diaphragm-the area that contacted the large tumor-was resected with both of the tumors under a thorascope. Despite a benign pathologic finding, a localized fibrous tumor of the pleura can then metastasize to the pleura due to contact. It was concluded that, because localized fibrous tumors of the pleura can occasionally metastasize to the area in contact with tumors, the intrathoracic cavity should be thoroughly observed using a thoracoscope.

Adult↗
PubMed2003

[Ultrasonic technologies in diagnosis and treatment of patients with surgical diseases of lungs and pleura].

The results of complex examination and treatment of 376 patients with different diseases of the lungs and pleura were analyzed. High-frequency ultrasound was used in 256 patients for diagnosis of lungs and pleura surgical diseases, 412 ultrasonic examinations were performed. Intraoperative treatment of pleura with low-frequency ultrasound was carried out 134 times for prophylaxis and treatment of acute postoperative pleura empyema in 120 patients operated on for malignant tumors and chronic purulent diseases of the lungs. High efficacy of high-frequency ultrasound for diagnosis of pleura empyema, diffuse and encapsulated pleurisy is demonstrated. Ultrasound-assisted pleural punctures an transthoracic aspiration biopsies permit to avoid complications. Ultrasonic examination of the lungs during surgery in patient suspected of lung cancer permits to study tumor structure. Treatment of pleura with low-frequency ultrasound and combination of this method with photodynamic therapy promote reliable sanation of pleural cavity. Limited rethoracotomy and treatment of pleura with low-frequency ultrasound is the method of choice in the treatment of acute postoperative empyema when there is no effect of conservative treatment.

Humans↗
PubMed1999

Desmoid tumors of the pleura: a clinicopathologic mimic of localized fibrous tumor.

Intrathoracic desmoid tumors of the pleura are unusual tumors that are often clinically and histologically confused with localized fibrous tumor of the pleura or benign neurogenic tumors. We studied four cases of intrathoracic desmoid tumor of the pleura and reviewed the clinical, histopathologic, and immunohistochemical features of the four patients. Two men and two women, ranging in age from 16 to 66 years (mean, 44 yr) comprised the study group. Three patients presented with chest pain and one with shortness of breath. Two patients had a history of associated trauma in the area of the tumor. Three of the lesions were based in the parietal pleura and one in the visceral pleura. Treatment included complete resection (two cases), subtotal resection (one case), and subtotal resection followed by radiation therapy and complete resection (one case). The mean tumor size was 12.5 cm, and all of the tumors exhibited a bosselated, firm, white, cut surface. The histologic features of intrathoracic desmoid tumors were similar to those of desmoid tumors at more conventional sites. Infiltration of the adjacent fat and skeletal muscle was invariably present. The tumor cells were immunoreactive for vimentin, desmin, smooth muscle actin, and muscle-specific actin in three of the four cases and were negative for S-100 protein. Follow-up to date shows stable residual disease at 12 months (one case) and two patients with no evidence of disease at 12 and 96 months, respectively. Intrathoracic desmoid tumors often exhibit clinical and radiographic features similar to localized fibrous tumor of the pleura. They generally have histologic and behavioral characteristics identical to those of desmoid tumors at conventional sites. Like desmoid tumors elsewhere, complete resection with negative margins is vital to prevent local recurrence. Desmoid tumor should be considered in the differential of localized fibrous tumor of the pleura.

Adolescent↗