scholarly journals Clinical Investigation of Benign Asbestos Pleural Effusion

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Nobukazu Fujimoto ◽  
Kenichi Gemba ◽  
Keisuke Aoe ◽  
Katsuya Kato ◽  
Takako Yokoyama ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Clinical Investigation ◽  
Asbestos Exposure ◽  
Disease Onset ◽  
Clinical Information ◽  
Mean Values ◽  
Pleural Thickening ◽  
Pleural Plaques ◽  
Before And After ◽  
History Of

There is no detailed information about benign asbestos pleural effusion (BAPE). The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1) history of asbestos exposure; (2) presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3) the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840 ng/mL, 23.9 IU/L, and 1.8 ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%). Asbestosis was present in 6 (5.5%) cases, rounded atelectasis was detected in 41 (37.3%) cases, and diffuse pleural thickening (DPT) was detected in 30 (27.3%) cases. One case developed lung cancer (LC) before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM) during the follow-up.

Introduction to Pleural Disease

Chest Imaging ◽  
2019 ◽  
pp. 155-158
Author(s):  
Christopher M. Walker
Keyword(s):  
Pleural Effusion ◽  
Asbestos Exposure ◽  
Pleural Space ◽  
Pulmonary Vasculature ◽  
Pleural Disease ◽  
Pleural Thickening ◽  
Pleural Plaques ◽  
Pleural Surface ◽  
Pleural Neoplasm ◽  
Ct Features

The chapter titled introduction to pleural disease discusses the imaging and clinical features of diseases of the pleura. The pleural space is a potential space located between the visceral and parietal pleural surfaces. Pleural effusion and pneumothorax are the most common manifestations of pleural disease and are caused by a wide variety of disease processes. Pleural thickening may be related to benign or malignant processes. Bilateral discontinuous nodular pleural thickening is characteristic of pleural plaques. Pleural thickening with calcification may also be seen in fibrothorax. Malignant pleural disease may manifest with pleural effusion, pleural nodules or masses, or a combination of the two. There are several CT features suggestive of malignant pleural thickening including circumferential pleural thickening, pleural nodules or masses, involvement of the mediastinal pleural surface, and pleural thickening measuring greater than 1 cm in thickness. Metastatic disease is the most common pleural neoplasm. Mesothelioma is uncommon but remains the most common primary pleural malignancy and is almost always seen in patients with previous asbestos exposure. Pleural abnormalities must be differentiated from pulmonary processes. Pleural masses may exhibit obtuse angles with the adjacent pleural surfaces, displace rather than engulf adjacent pulmonary vasculature, and may exhibit the incomplete border sign.

scholarly journals Yellow Nail Syndrome with Bilateral Pleural Plaques and Diffuse Pleural Thickening: A Mimic of Asbestos Related Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Adam Dallmann ◽  
Richard L. Attanoos
Keyword(s):  
Asbestos Exposure ◽  
Electron Microscopic ◽  
Yellow Nail Syndrome ◽  
Pleural Thickening ◽  
Pleural Plaques ◽  
Pulmonary Manifestations ◽  
Diffuse Pleural Thickening ◽  
Mineral Fibre ◽  
Asbestos Related Disease ◽  
Fibre Analysis

Yellow nail syndrome is a rare acquired condition of unknown aetiology associated with distinct nail discolouration/xanthonychia, pulmonary manifestations, and lymphoedema. Pleural plaques and diffuse pleural thickening are typically, although not exclusively, recognised as markers of prior commercial asbestos exposure. The presence of such biomarkers may assist an asbestos personal injury evaluation. A postmortem examination performed on a 72-year-old man with known long-standing yellow nail syndrome identified pleural plaques and diffuse pleural thickening. An evaluation of the occupational history identified no known asbestos exposure. Electron microscopic mineral fibre analysis detected no asbestos fibres. To the best of our knowledge, this is the only case of yellow nail syndrome in which these benign pleural changes are reported ex asbestos. Alternate causes for such pleural pathology were absent. There is merit in physicians and pathologists having an awareness of these new manifestations when considering claimed asbestos related changes during life and at postmortem.

Involvement of Interferon‐γ + 874A/T Polymorphism in the Pathogenesis of and Therapeutic Response to Immune Thrombocytopenia

2019 ◽  
Vol 50 (3) ◽  
pp. e42-e49
Author(s):  
Hadi Rezaeeyan ◽  
Kaveh Jaseb ◽  
Gholam Abas Kaydani ◽  
Ali Amin Asnafi ◽  
Mohammad Hosein Masbi ◽  
...  
Keyword(s):  
Immune Thrombocytopenia ◽  
Disease Onset ◽  
Interferon Γ ◽  
Control Group ◽  
Before And After ◽  
Causes Of Disease ◽  
History Of ◽  
Allele Specific ◽  
Polymerase Chain ◽  
And Control

Abstract Background Immune thrombocytopenia (ITP) is an autoimmune disease characterized by symptoms of thrombocytopenia and bleeding due to production of autoantibodies against platelets. Recently, the occurrence of polymorphisms has been identified as one of the main causes of disease onset. Methods To conduct this study, we recruited 140 patients and control individuals with no history of platelet loss. After collection of specimens, the prevalence of interferon-γ polymorphism was evaluated using the allele-specific oligonucleotide–polymerase chain reaction (ASO-PCR) technique and confirmed by sequencing techniques. Results The results showed that the frequency of the AA genotype was higher in the control group, compared with patients with ITP; however, in the acute and chronic groups, the frequency of the AT genotype was higher than that of the AA genotype. We also discovered that there was no significant correlation between platelet counts before and after treatment, nor in its related parameters with interferon (IFN)–γ polymorphism. Conclusion rs2430561 does not seem to have any role in ITP pathogenesis and treatment response.

Outcomes of sarcomatoid malignant pleural mesothelioma, a distinct clinical entity.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7084-7084
Author(s):  
Elisabetta Gattoni ◽  
Federica Grosso ◽  
Annalisa Roveta ◽  
Roberta Libener ◽  
Daniela Degiovanni ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Asbestos Exposure ◽  
Tumor Biology ◽  
Radiological Finding ◽  
Progression Free Survival ◽  
Large Series ◽  
First Line ◽  
Thoracic Pain ◽  
Palpable Mass ◽  
Pleural Thickening

7084 Background: Sarcomatoid malignant pleural mesotheliomas (SMPM), accounting for 10% of MPM, are resistant to chemotherapy (CT) with median survival in the range of 6 months. Here we report on clinical outcome of a large series of SMPM patients treated at our Oncological Department, located in a particularly asbestos-polluted area in Piedmont (Italy). Methods: Patients consecutively diagnosed, treated and included in our MesoDB between 1993 and 2010 were considered for this study. Clinical and pathological data, treatments, response to CT and outcomes were analyzed for the present study. Diagnosis was always confirmed by the same expert pathologist. Results: Data of 672 patients were considered for the analysis. Among these, 53 (8%) were diagnosed with SMPM (17F/36M). Median age was 67,6 years. Asbestos exposure was occupational certain in 12, possible in 15, domestic in 3 and environmental in 23. The predominant symptom at diagnosis was thoracic pain in 34 patients (64%), followed by dyspnea in 16 (30%), fatigue and weight loss in 2 and palpable mass in 1. The predominant radiological finding at diagnosis was diffuse pleural thickening in 23 patients (43%), pleural effusion in 14 (26%), pleural effusion and pleural thickening in 10 (19%), localized mass in 4 (8%), unknown in 2 (4%). Forty-eight patients received first line CT with the following regimens: carboplatin/cisplatin and pemetrexed in29, pemetrexed in 8, cisplatin and raltitrexed in 3, cisplatin and gemcitabine in 3, gemcitabine in 2, doxorubicin based combination in 3 patients. The median number of cycles was 4. Overall response rate to first line CT was as follows: 11 SD (21%), 31 PD (58%) and 6 (11%) patients were not evaluable for response. Median progression free survival was 3.3 (95%CI 2.6-4.1) months. Eleven patients received a second line CT and no responses or disease stabilization was observed. Median OS was 7.6 months. Conclusions: This large series of SMPM suggests that standard CT has only negligible impact on the prognosis, underlying a highly unmet clinical need. SMPM patients should be treated within phase I-II studies with investigational agents. Research should focus to a deeper knowledge of tumor biology and to the identification of druggable targets.

scholarly journals Malignant Pleural Mesothelioma with Marked Lymphatic Involvement: A Report of Two Autopsy Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Reiko Ideguchi ◽  
Kazuto Ashizawa ◽  
Saori Akashi ◽  
Michiko Shindo ◽  
Kazunori Minami ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Mesothelioma ◽  
Histopathological Examination ◽  
Lymphatic Spread ◽  
Mediastinal Lymphadenopathy ◽  
Pleural Mesothelioma ◽  
Pleural Thickening ◽  
History Of ◽  
Pulmonary Parenchyma ◽  
Lymphangitic Carcinomatosis

We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy. CT also showed a consolidative mass with bronchovascular bundle and septal thickening in the lungs suggesting pulmonary parenchymal involvement and the lymphangitic spread of the tumor. These CT findings mimicked lung cancer with pleuritis and lymphangitic carcinomatosis. Autopsy was performed in both cases. Macroscopically, the tumor cells infiltrated the lung with the marked lymphatic spread of the tumor. Microscopy also revealed that the tumor had invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor. Although this growth pattern is unusual, malignant pleural mesothelioma should be considered as the differential diagnosis, especially in patients with pleural lesions.

Asbestosis

Chest Imaging ◽  
2019 ◽  
pp. 383-386
Author(s):  
Joseph T. Azok
Keyword(s):  
Lung Cancer ◽  
Asbestos Exposure ◽  
Chest Ct ◽  
Pleural Effusions ◽  
Pleural Thickening ◽  
Asbestos Fibers ◽  
Related Disease ◽  
Pleural Plaques ◽  
Increased Risk ◽  
Asbestos Related Disease

Asbestosis is a fibrotic pneumoconiosis resulting from the inhalation of asbestos fibers, most commonly from occupational exposure. Chest radiographs and high-resolution chest CT can detect asbestos-related disease. Pleural abnormalities include pleural plaques, pleural effusions, pleural thickening, and mesothelioma. Pleural plaques serve as a marker of asbestos exposure and are the most common imaging abnormality found in patients exposed to asbestos. Parenchymal-induced lung disease includes pulmonary fibrosis, known as asbestosis, rounded atelectasis, and lung cancer. Asbestos exposure leads to an increased risk of both lung cancer and especially mesothelioma, which is rare in the absence of asbestos exposure.

scholarly journals Idiopathic pleural panniculitis with recurrent pleural effusion not associated with Weber-Christian disease

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 394-398 ◽  
Author(s):  
Paolo Laperuta ◽  
Filomena Napolitano ◽  
Rosa Maria Di Crescenzo ◽  
Pio Zeppa ◽  
Antonio Galderisi ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Pleural Effusion ◽  
Rare Case ◽  
Skin Lesions ◽  
Parietal Pleura ◽  
Fatty Tissue ◽  
Pleural Thickening ◽  
Multiple Biopsies ◽  
History Of ◽  
Recurrent Pleural Effusion

AbstractA 82-year-old patient with dyspnea and a recurrent history of pleural effusion was admitted into our unit. He performed a Chest computed tomography showing right pleural effusion. Video-assisted thoracoscopy (VATS) exploratory showed parietal pleural thickening of adipose tissue. The surgical procedure consisted, therefore, in the execution of multiple biopsies of the parietal pleura which appeared covered, on the whole surface, by islands of adipose tissue, without macroscopic pathological aspects. After the procedure was performed pleurodesis with talc. The definitive histological examination consisted of normal mesothelial cells surrounded by fatty tissue infiltrated by small lymphocytes in a patient without skin lesions or visceral or systemic signs of inflammatory involvement of the adipose tissue. We reported a rare case of idiopathic pleural panniculitis with recurrent pleural effusion not associated with Weber-Christian disease.

Malignes Mesotheliom: Die diagnostische Aussagekraft einer Computertomographie kritisch hinterfragen

2020 ◽  
Vol 8 (1) ◽  
pp. 22-23
Author(s):  
Stefanie Keymel
Keyword(s):  
Medical History ◽  
Diagnostic Yield ◽  
Asbestos Exposure ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Imaging Features ◽  
Pleural Thickening ◽  
Medical Thoracoscopy ◽  
History Of ◽  
Male Sex

Background: Medical history, thoracentesis, and imaging features are usually the first steps in the investigation of a possible malignant pleural effusion (MPE). Unfortunately, the diagnostic yield of thoracentesis in this situation is suboptimal even if the procedure is repeated, especially in the context of malignant pleural mesothelioma (MPM). The next step for confirming the diagnosis, if clinically appropriate, is thoracoscopy, but not all patients are fit to undergo this procedure, so the diagnosis is then based on the medical history and imaging features only. Objectives: Our objective was to evaluate the diagnostic value of the medical history and imaging features in MPM. Methods: We reviewed the imaging and medical charts of 92 patients with a final diagnosis of MPE included in our prospective medical thoracoscopy database. The clinical characteristics and imaging features of patients with primary MPE were compared with those of patients with secondary MPE. Results: Male sex (82 vs. 59%, p = 0.02), asbestos exposure (58 vs. 10%, p < 0.001), and mediastinal (68 vs. 33%, p = 0.04), diaphragmatic (75 vs. 31%, p = 0.001) and circumferential pleural thickening (55 vs. 19% p = 0.001) were significantly more frequent in MPM patients. In a multivariate linear regression model, only asbestos exposure (OR 11.2; 95% CI 3.4-36.9) and circumferential pleural thickening (OR 4.7; 95% CI 1.6-13.9) were significantly associated with a diagnosis of MPM. Conclusion: In situations where it is impossible to obtain adequate pleural samples to differentiate MPM from a secondary pleural malignancy, the combination of circumferential pleural thickening and a history of asbestos exposure may be sufficient to make a clinical diagnosis.

scholarly journals Spontaneous Pneumothorax: A Complication of Coronavirus Disease 2019 (COVID-19) Patients

2020 ◽  
Author(s):  
Qiannan Guo ◽  
Peiwen Yang ◽  
Kan-paatib Barnabo Nampoukime ◽  
Ke Ma ◽  
Haihao Wang
Keyword(s):  
Pleural Effusion ◽  
Spontaneous Pneumothorax ◽  
Clinical Investigation ◽  
Nucleic Acid Detection ◽  
X Ray ◽  
Oxygen Inhalation ◽  
Bilevel Positive Airway Pressure ◽  
Thoracic Drainage ◽  
Treatment Measures ◽  
History Of

Abstract Background At present, the coronavirus disease 2019 (COVID-19) is spreading all over the world. The occurrence of spontaneous pneumothorax in these patients might be higher than the fact, and we should pay high clinical attention to them. Method Data regarding clinical investigation, laboratory investigation, diagnosis, and treatment measures of 21 COVID-19 patients with spontaneous pneumothorax from January to March of 2020 were collected and analyzed in this study. Results Seven patients had a history of basic lung diseases. All patients used different methods of oxygen therapy before the occurrence of spontaneous pneumothorax according to the severity of the COVID-19, including 18 patients with ventilator-assisted breathing, 2 patients with bilevel positive airway pressure assisted breathing, and 1 patient with mask oxygen inhalation. All patients were confirmed cases of COVID-19 by chest CT (computed tomography) and virus nucleic acid detection and were found to have spontaneous pneumothorax through physical examination, bedside X-ray, and/or bedside ultrasound. 13 of 21 patients combined with pleural effusion at the same time. All the patients underwent closed thoracic drainage for spontaneous pneumothorax and the pleural effusion, if any. Nine patients died, and 12 patients recovered smoothly. Conclusion Spontaneous pneumothorax might be an overlooked complication of COVID-19 patients and may be associated with poor prognosis.

scholarly journals Malignant Mesothelioma Presenting After Resolution of a Seemingly Benign Asbestos Related Pleural Effusion

2019 ◽  
Keyword(s):  
Pleural Effusion ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Ct Scan ◽  
Asbestos Exposure ◽  
Signs And Symptoms ◽  
Cytological Analysis ◽  
Pleural Thickening ◽  
Palliative Intent

A male patient presented with a signs and symptoms of a respiratory tract infection associated with a pleural effusion. The effusion had negative cytological analysis and a CT scan showed mild pleural thickening. The effusion resolved completely on chest radiographs and the patient was discharged from the respiratory service, but the effusion recurred. After further investigations and elucidating significant asbestos exposure in the medical history, mesothelioma was eventually diagnosed. The patient is currently receiving chemotherapy with palliative intent. This paper highlights the importance of ongoing follow-up in a patient with a label of benign asbestos-related pleural effusion.

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