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1.
Clin Nucl Med ; 48(2): e84-e86, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36607379

RESUMO

ABSTRACT: We report a case of granulocyte colony-stimulating factor (G-CSF)-producing inflammatory myofibroblastic tumor of the pleura in a 71-year-old man. Contrast-enhanced CT demonstrated multiple pleural masses with pulmonary hilar lymph nodes swelling. 18F-FDG PET/CT demonstrated marked focal FDG uptake in the thoracic masses with diffuse uptake in the bone marrow. Based on the pathological findings and elevated serum G-CSF level, the patient was diagnosed as G-CSF-producing inflammatory myofibroblastic tumor. Because G-CSF-producing tumors demonstrate aggressive clinical course, early and accurate diagnosis is important.


Assuntos
Fluordesoxiglucose F18 , Neoplasias , Masculino , Humanos , Idoso , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Pleura , Fator Estimulador de Colônias de Granulócitos
2.
Am J Case Rep ; 24: e938696, 2023 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-36597286

RESUMO

BACKGROUND Epithelioid sarcoma is a rare tumor and that is extremely rare as a primary pleural neoplasm. On imaging, it may appear similar to malignant pleural mesothelioma; thus, it can be difficult to diagnose. CASE REPORT A 64-year-old Asian woman, who had a treatment history of cervix adenocarcinoma, was admitted with dyspnea and right massive pleural effusion. Chest drainage was performed, and malignant cells were found in the pleural effusion. The malignant cells were thought to be metastasized from previous cervical cancer. We continued pleural drainage; however, the volume of the pleural effusion did not decrease. On the 5th hospital day, the chest tube became occluded. Computed tomography showed structures similar to empyema. Pleural irrigation and fibrinolytic therapy did not improve her condition. Empyema curettage was performed on the 14th hospital day. The resected pleura was submitted for pathological examination and showed tumor lesion but not metastatic adenocarcinoma of the cervix. The intrathoracic tumor grew extremely rapidly, and the patient died of respiratory failure on postoperative day 8 (22nd hospital day) before a diagnosis could be made. The final pathological diagnosis obtained on the 34th hospital day was epithelioid sarcoma. CONCLUSIONS For patients who appear to have empyema complicated by neoplastic lesions, a histopathological examination should also be performed to ensure accurate diagnosis. In addition, if a tumorous lesion is detected and it is neither metastatic nor malignant pleural mesothelioma, pleural epithelioid sarcoma should be added to the differential diagnosis in the presence of a rapidly growing and histologically difficult-to-diagnose pleural tumor.


Assuntos
Adenocarcinoma , Mesotelioma Maligno , Mesotelioma , Derrame Pleural , Neoplasias Pleurais , Sarcoma , Feminino , Humanos , Pessoa de Meia-Idade , Pleura/patologia , Mesotelioma Maligno/complicações , Mesotelioma Maligno/patologia , Mesotelioma/diagnóstico , Mesotelioma/cirurgia , Mesotelioma/patologia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/cirurgia , Derrame Pleural/patologia , Adenocarcinoma/patologia , Sarcoma/diagnóstico , Sarcoma/cirurgia
3.
J Cardiothorac Surg ; 18(1): 15, 2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36627632

RESUMO

BACKGROUND: Stage III tuberculous empyema is a common disease of tuberculosis. Traditionally, it has been treated by thoracotomy or video-assisted thoracoscopic surgery with two to four incisions. But conventional surgery has large trauma, large bleeding volume and long recovery time. To our knowledge it is the first report of surgery for stage III tuberculous empyema with a mini single-port approach. CASE PRESENTATION: A 23-year-old woman admitted to our hospital with complaints of intermittent chest pain for half a year. We got the diagnosis of stage III tuberculous empyema after medical treatment. Considering that the patient was young and unmarried, we decided to perform minimally invasive pleural decortication through a 2.5 cm single port. The operation time was 240 min, and blood loss was 100 ml. The patient recovered well and postoperative pain was mild. CONCLUSION: This case demonstrates that single-port VATS with a smaller incision for the Stage III tuberculous empyema should be considered in well selected patients.


Assuntos
Empiema Pleural , Empiema Tuberculoso , Feminino , Humanos , Adulto Jovem , Adulto , Cirurgia Torácica Vídeoassistida , Empiema Tuberculoso/cirurgia , Empiema Pleural/cirurgia , Estudos Retrospectivos , Pleura
4.
J Cardiothorac Surg ; 18(1): 13, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36627669

RESUMO

BACKGROUND: Primary spontaneous pneumothorax occasionally relapses, even after bullectomy; therefore, coverage of the bullectomy staple line for pleural reinforcement is common in Japan. However, the appropriate covering materials have not yet been determined. METHODS: This was a longitudinal prospective cohort study. Data were available for patients aged < 40 years with primary spontaneous pneumothorax who underwent their first thoracoscopic bullectomy between July 2015 and June 2021. We used oxidized regenerated cellulose (ORC) sheets from July 2015 to June 2018, and polyglycolic acid (PGA) sheets from July 2018 to June 2021. The postoperative recurrence-free survival rate was evaluated. The characteristics of the recurrent cases (radiographic, intraoperative, and pathological findings) were also evaluated. The extent of pleural adhesions was classified into the following three groups: none, medium, or extensive. RESULTS: A total of 187 patients were included in the study. There were 92 and 95 participants in the ORC and PGA sheet groups, respectively. The postoperative recurrence-free survival rates were significantly higher in the PGA sheet group than in the ORC sheet group (ORC group vs. PGA group, 82.9% vs. 95.4%, p = 0.031). In recurrent cases, there was a significant difference in terms of pleural adhesion (0.0% [12 of 12, none] vs. 100.0% [four of four, extensive], p < 0.001). CONCLUSIONS: Compared with ORC sheets, PGA sheets are an effective material for preventing early recurrence of primary spontaneous pneumothorax. Strong local pleural adhesions potentially contribute to decreasing recurrence.


Assuntos
Celulose Oxidada , Pneumotórax , Humanos , Pneumotórax/prevenção & controle , Pneumotórax/cirurgia , Estudos Prospectivos , Pleura/cirurgia , Celulose Oxidada/uso terapêutico , Celulose Oxidada/farmacologia , Ácido Poliglicólico/uso terapêutico , Cirurgia Torácica Vídeoassistida , Estudos Retrospectivos
5.
J Cell Physiol ; 238(1): 274-284, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36502471

RESUMO

Pleural epithelial adaptations to mechanical stress are relevant to both normal lung function and parenchymal lung diseases. Assessing regional differences in mechanical stress, however, has been complicated by the nonlinear stress-strain properties of the lung and the large displacements with ventilation. Moreover, there is no reliable method of isolating pleural epithelium for structural studies. To define the topographic variation in pleural structure, we developed a method of en face harvest of murine pleural epithelium. Silver-stain was used to highlight cell borders and facilitate imaging with light microscopy. Machine learning and watershed segmentation were used to define the cell area and cell perimeter of the isolated pleural epithelial cells. In the deflated lung at residual volume, the pleural epithelial cells were significantly larger in the apex (624 ± 247 µm2 ) than in basilar regions of the lung (471 ± 119 µm2 ) (p < 0.001). The distortion of apical epithelial cells was consistent with a vertical gradient of pleural pressures. To assess epithelial changes with inflation, the pleura was studied at total lung capacity. The average epithelial cell area increased 57% and the average perimeter increased 27% between residual volume and total lung capacity. The increase in lung volume was less than half the percent change predicted by uniform or isotropic expansion of the lung. We conclude that the structured analysis of pleural epithelial cells complements studies of pulmonary microstructure and provides useful insights into the regional distribution of mechanical stresses in the lung.


Assuntos
Células Epiteliais , Pulmão , Pleura , Animais , Camundongos , Pulmão/anatomia & histologia , Aprendizado de Máquina , Pleura/anatomia & histologia , Respiração , Tórax , Células Epiteliais/citologia
6.
Indian J Tuberc ; 69(4): 635-640, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36460401

RESUMO

AIMS: The aim of the study was to determine the performance of Xpert MTB/RIF assay in diagnosing tuberculosis on thoracoscopic pleural biopsies in exudative pleural effusion. METHODS: Patients who underwent thoracoscopic pleural biopsy in the defined period were included in the study. Histopathology was done for all and Xpert MTB RIF assay and AFB culture of pleural biopsy specimen and pleural fluid were done as per the clinician's discretion. RESULTS: Total of 110 patients underwent pleural biopsy and tissue Xpert MTB/RIF and MTB culture were done in 29 patients. XpertMTB/RIF assay and MTB culture had a sensitivity of 59% and 35% respectively and specificity of specificity of 100. CONCLUSION: The study described the ability of XPERT MTB/RIF in getting additional diagnostic information from thoracoscopic Pleural biopsy. Pleural biopsy Xpert MTB/RIF had sensitivity of 59% and specificity of 100% in diagnosing TPE. In addition to the diagnosis, Xpert MTB/RIF can also give valuable information about rifampicin resistance too. XPERT MTB/RIF assay also helped in getting diagnosis when histopathology alone was not able to confirm or rule out the diagnosis of TPE. Pleural fluid ADA of 38 IU/L had a sensitivity of 71% and a specificity of 86% for diagnosis of TPE in present study.


Assuntos
Derrame Pleural , Rifampina , Humanos , Rifampina/farmacologia , Rifampina/uso terapêutico , Pleura , Derrame Pleural/diagnóstico , Biópsia , Exsudatos e Transudatos
7.
PLoS One ; 17(12): e0276978, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36454800

RESUMO

Pleural mesothelial cells are the predominant cell type in the pleural cavity, but their role in the pathogenesis of pleural diseases needs to be further elucidated. 3D organotypic models are an encouraging approach for an in vivo understanding of molecular disease development. The aim of the present study was to develop a 3D organotypic model of the pleural mesothelium. Specimens of human pleura parietalis were obtained from patients undergoing surgery at the University Hospital Leipzig, Germany. 3D co-culture model of pleura was established from human pleural mesothelial cells and fibroblasts. The model was compared to human pleura tissue by phase-contrast and light microscopy, immunochemistry and -fluorescence as well as solute permeation test. Histological assessment of the 3D co-culture model displayed the presence of both cell types mimicking the morphology of the human pleura. Vimentin and Cytokeratin, PHD1 showed a similar expression pattern in pleural biopsies and 3D model. Expression of Ki-67 indicates the presence of proliferating cells. Tight junctional marker ZO-1 was found localized at contact zones between mesothelial cells. Each of these markers were expressed in both the 3D co-culture model and human biopsies. Permeability of 3D organotypic co-culture model of pleura was found to be higher for 70 kDa-Dextran and no significant difference was seen in the permeability for small dextran (4 kDa). In summary, the presented 3D organoid of pleura functions as a robust assay for pleural research serving as a precise reproduction of the in vivo morphology and microenvironment.


Assuntos
Pleura , Doenças Pleurais , Humanos , Técnicas de Cocultura , Dextranos , Cavidade Pleural
8.
Medicina (Kaunas) ; 58(12)2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36557044

RESUMO

Background and Objectives: This study was designed to evaluate platelet-rich plasma (PRP) as a method of pleurodesis in a rabbit model. Pleurodesis with PRP was compared against the gold-standard use of talc. The secondary evaluation assessed the ideal time for achieving pleurodesis. Materials and Methods: 25 healthy New Zealand white rabbits were assigned to three groups, as follows: 12 animals in the first and second groups, as well as one animal with no intervention in the final group, which was used as a control. The talc pleurodesis group (baseline) underwent pleurodesis with sterile talc, which is the gold-standard sclerosing agent used for pleurodesis. The PRP group underwent pleurodesis using autologous PRP. The last group had one rabbit with no intervention. A total of 12 rabbits (n = 6 for the talc pleurodesis group and n = 6 for the PRP group) were sacrificed 3 days (72 h) after the intervention, and 12 rabbits (n = 6 for the talc pleurodesis group and n = 6 for the PRP group) were sacrificed 6 days (144 h) after the intervention. In both the talc and PRP group, FBC and CRP were measured before the intervention and in 3 or 6 days afterwards, respectively. The pleura and the lungs were evaluated histopathologically. Results: Macroscopically, there were no statistically significant differences between the two groups. In terms of microscopic findings, there were no statistically significant differences in inflammatory reactions provoked in the visceral and parietal pleura between the PRP and talc. In addition, with talc pleurodesis, a foreign-body reaction was observed in about 50% of the cases, which was not observed with PRP. In terms of inflammation between 3 and 6 days, there were no statistically significant differences with PRP, there was only a statistically significant difference between 3 and 6 days regarding the parietal pleura in the talc group. Conclusions: The instillation of autologous PRP in the pleural cavity shows promise in achieving pleurodesis. The efficacy of PRP as a pleurodesis agent should be examined further.


Assuntos
Plasma Rico em Plaquetas , Pleurodese , Coelhos , Animais , Pleurodese/métodos , Talco , Pleura , Pulmão
9.
Praxis (Bern 1994) ; 111(15): 871-877, 2022 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-36415984

RESUMO

Pulmonary Opacities - What Lies Beneath? Abstract. Abstract: Pulmonary opacities are among the most common findings that general practitioners and internists have to interpret in everyday life. Conventional chest x-rays are still important, but computed tomograms often provide additional information. Patient history, clinical examination but also additionally collected laboratory findings are important prerequisites for the interpretation of imaging studies. Likewise, radiological patterns should be recognized and correctly described. The density, distribution to one or both sides, basal or apical, unifocal or multifocal, also the involvement of the interstitial tissue, bronchioles, the alveolar space and pleura can provide decisive differential diagnostic information. Space-occupying or shrinking processes may be suspected on behalf of the course of pleural lines. Tumours may be differentiated from shrinking lung volume as seen in atelectasis by shift of the mediastinum or the shape of pleural lines. Occasionally control images can support the interpretation of the radiological results.


Assuntos
Diagnóstico por Imagem , Pleura , Humanos , Pleura/diagnóstico por imagem
10.
Clinics (Sao Paulo) ; 77: 100133, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36375297

RESUMO

OBJECTIVE: The aim is to evaluate the diagnostic value of Activin A levels in serum and pleural fluid on Parapneumonic Pleural Effusion (PPE). METHODS: The authors collected serum and pleural fluid from 86 PPE and 37 Non-PPE (NPPE) patients. Including Activin A, levels of biomarkers such as Lactate Dehydrogenase (LDH), Procalcitonin (PCT), and C-Reactive Protein (CRP) were measured. All factors were calculated for association with days after admission. The diagnostic potential of biomarkers on PPE was considered by Receiver Operating Characteristic (ROC) curve analysis. RESULTS: Levels of Activin A in serum and pleural fluid of PPE patients were significantly higher than those of the NPPE patients. Moreover, concentrations of Activin A in pleural fluid showed a more obvious relevant days after admission. ROC curve analysis found that Activin A in pleural fluid had AUCs of 0.899 with 93% sensitivity and 84% specificity for PPE diagnosis. CONCLUSION: Activin A in pleural fluid correlated with disease severity could act to diagnose PPE.


Assuntos
Derrame Pleural , Humanos , Derrame Pleural/diagnóstico , Exsudatos e Transudatos/metabolismo , Pleura , Curva ROC , Biomarcadores/metabolismo , Diagnóstico Diferencial
11.
Zhonghua Jie He He Hu Xi Za Zhi ; 45(11): 1071-1072, 2022 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-36344223

RESUMO

The consensus published in this issue was developed over a period of 1.5 years, and it was discussed and revised by the expertpanel from pleural and mediastinal diseases working group (preparatory) of Chinese Thoracic Society and external experts in several meetings. This article introduced the purpose, process and thinking in the writing of the consensus, hoping to provide a reference for readers to understand the content of this consensus and to make reasonable application in clinical practice.


Assuntos
Medicina Tradicional Chinesa , Derrame Pleural , Humanos , Consenso , Derrame Pleural/diagnóstico , Pleura , China
12.
Rev. colomb. neumol ; 34(2): 97-106, July-Dec. 2022.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1412946

RESUMO

Se presenta el caso de un paciente de 82 años, con tumor intratorácico de crecimiento rápido, con aumento progresivo de la disnea, antecedentes de enfermedad coronaria y baja función cardíaca, obesidad y síndrome de apnea de sueño, quien fue sometido a toracotomía y a quien se le diagnosticó un tumor solitario fibroso de la pleura, tumor de muy baja frecuencia, adherido en forma sésil al pericardio, lo cual lo hace aún menos frecuente. Se hace una revisión general de las posibilidades terapéuticas, el diagnóstico histológico y por inmunohistoquímica, así como los criterios de benignidad y malignidad para este tipo de tumor, que son en su mayoría de buen pronóstico.


We present the case of an 82-year-old patient with a rapidly growing intrathoracic tumor, progressive increase in dyspnea, and a history of coronary heart disease and low cardiac function, obesity, and sleep apnea syndrome, who underwent thoracotomy and who was diagnosed with a Solitary Fibrous Tumor of the Pleura, a very low frequency tumor, adhered in sessile form to the pericardium, which makes it even less frequent. A general review is made of the therapeutic possibilities, the histological and immunohistochemical diagnosis, as well as the criteria of benignity and malignancy for this type of tumor, most of which have a good prognosis.


Assuntos
Humanos , Pleura , Tumores Fibrosos Solitários , Tumor Fibroso Solitário Pleural , Mediastino , Imuno-Histoquímica , Doença das Coronárias
13.
Radiographics ; 42(7): 1940-1955, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36269669

RESUMO

Pleural fistula is an abnormal communication between the pleural cavity and an adjacent structure. The interplay of anatomic and physiologic factors including proximity to various intrathoracic structures, deep pleural recesses, and negative pleural pressures makes the pleura an easy victim of fistulization. Iatrogenic creation followed by necrotizing infections and malignancies are the most common causes. While the overall incidence and size of postsurgical pleural fistulas are decreasing with increased adoption of vascularized flaps for high-risk resections, the smaller fistulas that develop in the setting of post-radiation therapy changes, with necrotizing infections in immunosuppressed patients, and with use of newer antiangiogenic chemotherapies can be challenging to visualize directly. Imaging signs in clinical practice are often subtle and indirect. Multimodality imaging and biochemical pleural fluid analysis can offer important adjunctive information when a diagnosis is only suggested with the first imaging study. Certain pleural fistulas are inconsequential, some spontaneously close with or without diversion of flow or use of positive-pressure ventilation, while others carry a higher risk of complications or recurrence. Estimated fistula size, factors that impair healing, and the possibility of diversion are important considerations when deciding between endoscopic or surgical closure. The authors have tailored this article for a general imager or clinical practitioner and review 10 types of pleural fistulas, ranging from routine to rare, with regard to their etiology, pathophysiology, clinical cues, imaging features, nuances of pleural fluid analysis, and management options available today. ©RSNA, 2022.


Assuntos
Fístula , Doenças Pleurais , Humanos , Fístula/etiologia , Pleura , Retalhos Cirúrgicos
14.
Int J Mol Sci ; 23(19)2022 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-36233262

RESUMO

Mesothelial cells (MCs) play a classic role in maintaining homeostasis in pleural, peritoneal, and pericardial cavities. MCs work as lubricants to reduce friction between organs, as regulators of fluid transport, and as regulators of defense mechanisms in inflammation. MCs can differentiate into various cells, exhibiting epithelial and mesenchymal characteristics. MCs have a high potential for differentiation during the embryonic period when tissue development is active, and this potential decreases through adulthood. The expression of the Wilms' tumor suppressor gene (Wt1), one of the MC markers, decreased uniformly and significantly from the embryonic period to adulthood, suggesting that it plays a major role in the differentiation potential of MCs. Wt1 deletion from the embryonic period results in embryonic lethality in mice, and even Wt1 knockout in adulthood leads to death with rapid organ atrophy. These findings suggest that MCs expressing Wt1 have high differentiation potential and contribute to the formation and maintenance of various tissues from the embryonic period to adulthood. Because of these properties, MCs dynamically transform their characteristics in the tumor microenvironment as cancer-associated MCs. This review focuses on the relationship between the differentiation potential of MCs and Wt1, including recent reports using lineage tracing using the Cre-loxP system.


Assuntos
Lubrificantes , Pleura , Adulto , Animais , Diferenciação Celular , Humanos , Camundongos
15.
BMJ Case Rep ; 15(10)2022 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-36207058

RESUMO

A woman in her early 70s was found to have incidental finger clubbing at a fracture clinic consultation for an unrelated problem. She reported no associated respiratory symptoms and was referred back to her General Practitioner for further investigation. A chest radiograph revealed a large left-sided mass. This was characterised as a pleural-based mass on CT, resulting in localised atelectasis and mediastinal shift. A CT guided biopsy revealed histology consistent with a solitary fibrous tumour of the pleura and the patient was referred for thoracotomy and resection.


Assuntos
Osteoartropatia Hipertrófica Secundária , Neoplasias Pleurais , Tumor Fibroso Solitário Pleural , Feminino , Humanos , Hipertrofia , Biópsia Guiada por Imagem , Osteoartropatia Hipertrófica Secundária/etiologia , Pleura/patologia , Neoplasias Pleurais/patologia , Tumor Fibroso Solitário Pleural/diagnóstico , Tumor Fibroso Solitário Pleural/diagnóstico por imagem , Tomografia Computadorizada por Raios X
16.
Acta Med Okayama ; 76(4): 485-488, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36123165

RESUMO

Aspergillosis is an infection caused by Aspergillus species, and it manifests in various clinical presentations. We describe the case of a 73-year-old man with a small area of thickening on the thoracic wall detected by computed tomography. Surgical resection confirmed the diagnosis of an Aspergillus abscess. We report this case in view of the rarity of Aspergillus abscess localized to a parietal pleura without any signs of lung parenchymal involvement. After a thorough literature review, we consider this could be the first report of this manifestation. Accumulation of similar cases will be necessary to help spread recognition of this condition.


Assuntos
Aspergilose , Pleura , Abscesso/diagnóstico , Idoso , Aspergilose/complicações , Aspergilose/diagnóstico , Humanos , Pulmão , Masculino , Tomografia Computadorizada por Raios X
17.
Br J Radiol ; 95(1140): 20220235, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36125174

RESUMO

Intrathoracic fat-containing lesions may arise in the mediastinum, lungs, pleura, or chest wall. While CT can be helpful in the detection and diagnosis of these lesions, it can only do so if the lesions contain macroscopic fat. Furthermore, because CT cannot demonstrate microscopic or intravoxel fat, it can fail to identify and diagnose microscopic fat-containing lesions. MRI, employing spectral and chemical shift fat suppression techniques, can identify both macroscopic and microscopic fat, with resultant enhanced capability to diagnose these intrathoracic lesions non-invasively and without ionizing radiation. This paper aims to review the CT and MRI findings of fat-containing lesions of the chest and describes the fat-suppression techniques utilized in their assessment.


Assuntos
Parede Torácica , Tomografia Computadorizada por Raios X , Humanos , Tomografia Computadorizada por Raios X/métodos , Imageamento por Ressonância Magnética/métodos , Mediastino , Pleura
18.
BMC Cancer ; 22(1): 958, 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068487

RESUMO

BACKGROUND: Pleural deformation is associated with the invasiveness of lung adenocarcinoma(LAC). Our study focused on the pathological components of the area adjacent pleura in pulmonary pure ground-glass nodules(pGGNs) with pleural deformations(P-pGGNs) confirmed to be invasive LAC without visceral pleural invasion (VPI) pathologically. METHODS: Computed tomography(CT) imaging features of nodules and pathological components of the area adjacent pleura were analyzed and recorded. Statistical analysis was performed for subgroups of P-pGGNs. RESULTS: The 81 enrolled patients with 81 P-pGGNs were finally involved in the analysis. None of solid/micropapillary group and none of VPI was observed, 54 alveoli/lepidics and 27 acinar/papillarys were observed. In P-pGGN with acinar/papillary components of the area adjacent pleura, invasive adenocarcinoma (IAC) was more common compared to minimally invasive adenocarcinoma (MIA, 74.07% vs. 25.93%; p < 0.001). The distance in alveoli/lepidic group was significantly larger (1.50 mm vs. 0.00 mm; p < 0.001) and the depth was significantly smaller (2.00 mm vs. 6.00 mm; p < 0.001) than that in acinar/papillary group. The CT attenuation value, maximum diameter and maximum vertical diameter was valuable to distinguish acinar/papillary group form alveoli/lepidic group(p < 0.05). The type d pleural deformation was the common pleural deformation in IAC(p = 0.028). CONCLUSIONS: The pathological components of the area adjacent pleura in P-pGGN without VPI confirmed to be invasive LAC could included alveoli/lepidics and acinar/papillarys. Some CT indicators that can identify the pathological invasive components of the area adjacent pleura in P-pGGNs.


Assuntos
Adenocarcinoma de Pulmão , Adenocarcinoma , Neoplasias Pulmonares , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Invasividade Neoplásica , Pleura/diagnóstico por imagem , Pleura/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
19.
Arkh Patol ; 84(5): 28-34, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36178219

RESUMO

The article contains an overview of the new WHO classification of thoracic tumors (2021). As in the previous edition of 2015, considerable attention is paid to neoplasms of the lungs and pleura. The article presents current data on molecular genetic features and morphological manifestations of a number of new lung tumors, with a detailed histological and immunohistochemical data. Thoracis undifferentiated tumor with SMARCA4 deficiency and bronchiolar adenoma are described. Emphasis is placed on the algorithms of morphological diagnostics, including a complete description of the tumor and facilitating the study in the practice of a pathologist. The main morphological criteria of mesothelial tumors of the pleura are given; describes in detail the procedure for assessing the degree of malignancy of diffuse epithelioid pleural mesothelioma and non-mucinous lung adenocarcinomas.


Assuntos
Neoplasias Pulmonares , Mesotelioma , Neoplasias Pleurais , DNA Helicases , Diagnóstico Diferencial , Humanos , Pulmão/patologia , Neoplasias Pulmonares/classificação , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Mesotelioma/classificação , Mesotelioma/diagnóstico , Mesotelioma/patologia , Proteínas Nucleares , Pleura/patologia , Neoplasias Pleurais/classificação , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/patologia , Fatores de Transcrição , Organização Mundial da Saúde
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