STUDY OF HISTOPATHOLOGICAL SPECTRUM OF LESIONS IN PLUERAL BIOPSY.

2021 ◽  
pp. 12-13
Author(s):  
Siva Chaithanya Bangi ◽  
Vivek Krishna ◽  
Triveni B
Keyword(s):  
Pleural Effusion ◽  
Lung Tumor ◽  
Correct Diagnosis ◽  
Cost Effective ◽  
Limiting Factors ◽  
Pleural Biopsy ◽  
Pleural Diseases ◽  
Pleural Thickening ◽  
Neoplastic Lesions ◽  
A Prospective Study

Pleural diseases, both neoplastic (primary and metastatic) and non-neoplastic, exhibit similar clinical, radiographic and gross features, including pleural pain, pleural-based masses or pleural thickening, and pleural effusions. However, the treatments and prognoses of these diverse conditions vary greatly. As such, accurate diagnosis of pleural disease is critical, and histological interpretation of pleural biopsies is extremely important for correct diagnosis. Methods: A prospective study was conducted in Department of Pathology, Government Chest hospital, Osmania Medical college, Telangana, during March 2019 to March 2020 that evaluated 65 patients with history of pleural effusion, mass involving pleura and pleural thickening. Detailed history, clinical examination, Radiological Imaging along with pleural biopsy with Abram needle was performed in all the 65 Patients. The biopsy specimens were formalin xed and the sections were stained with Hematoxylin and Eosin. Result: The patients aged from 15 to 90 years, average age at presentation was 46.2 yrs. Of total 65 cases 20 were female (31%) and 45(69%) were male. The commonest clinical presentation was shortness of breath with cough. In 65 cases pleural effusion in 58 cases (89%), mass lesion in the lung 6 cases (9%) and pleural thickening 1 case (2%) was preliminary nding on radiology. Histo-pathological evaluation revealed 46 cases (69%) were inammatory lesions. 8cases (12%) were neoplastic lesions and 11(19%) cases were inadequate sampling. Of 46 inammatory lesions 12 cases (26%) were granulomatous lesions. Of 8 neoplastic lesions 1 case (12%) was malignant mesothelioma with calretinin and WT1 positive on Immunohistochemistry. Conclusion: A Pleural Biopsy is a safe, cost effective modality of investigation which not only guides us to diagnosis but also helps in nding out metastatic involvement in a primary Lung tumor. In inammatory lesions it at times aids in differentiating between granulomatous versus non granulomatous when correlated along with the ndings of pleural uid analysis. But lack of expertise in performing the blind procedure and sample inadequacy are some of the limiting factors in having good satisfactory Pleural Biopsy.

scholarly journals Practice Pearls for Performing Pleural Ultrasound with Focus on Pleural Effusion and Pleural Thickening

2017 ◽  
Vol 12 (02) ◽  
pp. 23
Author(s):  
Macarena R Vial ◽  
Horiana B Grosu ◽  
◽  
Keyword(s):  
Pleural Effusion ◽  
Low Cost ◽  
Standard Of Care ◽  
Pleural Diseases ◽  
Pleural Thickening ◽  
Therapeutic Procedures

Ultrasonography can provide guidance for several diagnostic and therapeutic procedures, and is now considered the standard of care for the evaluation of patients with pleural diseases. Ultrasonography is a particularly useful tool in the evaluation of pleural effusion and pleural thickening, with advantages such as portability, low cost, and safety.

scholarly journals Endothelin-1 Induces Mesothelial Mesenchymal Transition and Correlates with Pleural Fibrosis in Tuberculous Pleural Effusions

2019 ◽  
Vol 8 (4) ◽  
pp. 426 ◽  
Author(s):  
Zhung-Han Wu ◽  
Jie-Heng Tsai ◽  
Cheng-Ying Hsieh ◽  
Wei-Lin Chen ◽  
Chi-Li Chung
Keyword(s):  
Pleural Effusion ◽  
Smooth Muscle Actin ◽  
Mesenchymal Transition ◽  
Pleural Diseases ◽  
Pleural Thickening ◽  
Pleural Fibrosis ◽  
Parapneumonic Pleural Effusion ◽  
Insight Into

Endothelin (ET)-1 is involved in various fibrotic diseases. However, its implication in pleural fibrosis remains unknown. We aimed to study the profibrotic role of ET-1 in tuberculous pleural effusion (TBPE). The pleural effusion ET-1 levels were measured among 68 patients including transudative pleural effusion (TPE, n = 12), parapneumonic pleural effusion (PPE, n = 20), and TBPE (n = 36) groups. Pleural fibrosis, defined as radiological residual pleural thickening (RPT) and shadowing, was measured at 12-month follow-up. Additionally, the effect of ET-1 on mesothelial mesenchymal transition (MMT) and extracellular matrix (ECM) producion in human pleural mesothelial cells (PMCs) was assessed. Our findings revealed that effusion ET-1 levels were significantly higher in TBPE than in TPE and PPE, and were markedly higher in TBPE patients with RPT >10 mm than those with RPT ≤10 mm. ET-1 levels correlated substantially with residual pleural shadowing and independently predicted RPT >10 mm in TBPE. In PMCs, ET-1 time-dependently induced MMT with upregulation of α-smooth muscle actin and downregulation of E-cadherin, and stimulated ECM production; furthermore, ET receptor antagonists effectively abrogated these effects. In conclusion, ET-1 induces MMT and ECM synthesis in human PMCs and correlates with pleural fibrosis in TBPE. This study confers a novel insight into the pathogenesis and potential therapies for fibrotic pleural diseases.

Objective Thoracoscopic Criteria in Differentiation between Benign and Malignant Pleural Effusions

Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Mohamed Ellayeh ◽  
Eihab Bedawi ◽  
Radhika Banka ◽  
Anand Sundaralingam ◽  
Vineeth George ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Parietal Pleura ◽  
Anatomical Location ◽  
Diagnostic Modality ◽  
Pleural Diseases ◽  
Pleural Thickening ◽  
Video Footage ◽  
Medical Thoracoscopy ◽  
Malignant Group ◽  
Benign Pleural Effusion

<b><i>Background:</i></b> Thoracoscopy is the “gold standard” diagnostic modality for investigation of suspected pleural malignancy. It is postulated that meticulous assessment of the pleural cavity may be adequate to indicate malignancy through the macroscopic findings of nodules, pleural thickening, and lymphangitis. We attempted to critically assess this practice, by precisely defining objective macroscopic criteria which might differentiate benign from malignant pleural diseases according to intrapleural pattern and anatomical location, and thereby to explore the predilection of abnormalities to specific sites on pleural surfaces. <b><i>Methods:</i></b> A structured review of recorded video footage from medical thoracoscopy procedures in 96 patients was conducted by 2 independent assessors. Abnormalities were scored on agreed, objective criteria for the presence of nodules, lymphangitis and inflammation on each of the costoparietal, visceral and diaphragmatic surfaces. The costoparietal pleura was divided into 6 levels (apical, middle, and inferior surfaces of the lateral and posterior parietal pleura). The anterior surface of the costoparietal pleura was excluded from analysis after interim review as this surface was rarely seen. <b><i>Results:</i></b> In the benign group, inflammation was the predominant finding in 65% (<i>n</i> = 33; costoparietal), 44% (<i>n</i> = 21; visceral), and 42% (<i>n</i> = 15; diaphragmatic). Nodules were detected in 24% (<i>n</i> = 12; costoparietal), 8% (<i>n</i> = 4; visceral), and 8% (<i>n</i> = 3; diaphragmatic). The most affected surfaces with inflammation were the middle lateral (60%) and the inferior lateral (57.8%) parts of the costoparietal pleura. In the malignant group, nodules were the predominant finding according to surface in 73% (<i>n</i> = 33; costoparietal), 32% (<i>n</i> = 13; visceral) and 48% (<i>n</i> = 17; diaphragmatic). Inflammation was detected in 44% (<i>n</i> = 20; costoparietal), 25% (<i>n</i> = 10; visceral), and 29% (<i>n</i> = 10; diaphragmatic). The most affected surfaces with nodules were the middle lateral (67.4%) and inferior lateral (66.7%) costoparietal pleural surfaces. <b><i>Conclusion:</i></b> This is the first detailed, anatomical description of abnormalities in the pleural space during thoracoscopy. While nodules were the predominant pattern in malignant pleural effusion, they were detected in 24% of benign diagnoses. Detection of nodules in &#x3e;1 area of the costoparietal pleura was in favor of a malignant diagnosis. Inflammation was the predominant pattern in benign pleural effusion. Our results suggest that macroscopic nodules in malignant diagnoses have a predilection for the middle and inferior surfaces of the lateral costoparietal pleura.

scholarly journals Ultrasonographyin diagnosis of thoracic diseases

2010 ◽  
Vol 63 (1-2) ◽  
pp. 86-90 ◽  
Author(s):  
Ruza Stevic ◽  
Radoslav Jakovic ◽  
Dragan Masulovic ◽  
Ljudmila Nagorni-Obradovic ◽  
Natasa Mujovic ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Thoracic Wall ◽  
Large Tumor ◽  
Lung Lesions ◽  
Tumor Mass ◽  
Pleural Diseases ◽  
Pleural Thickening ◽  
Thoracic Diseases ◽  
Chest Disease ◽  
Peripheral Lung

Introduction. Chest sonography was used until recently mainly for diagnosis of pleural diseases. High resolution ultrasound machines enable ultrasound application not only in pleural diseases detection, but in diagnosing peripheral lung and mediastinal lesions. Ultrasonography can define the origin and structure of the lesion of thoracic wall, pleural and peripheral lung lesions and mediastinal lesions. Pleural lesions. Ultrasonography is very useful in diagnosing pleural effusion and distinguishing pleural fluid and pleural thickening. This method can also differentiate transudate from exudates and tumor mass from pleural thickening. Lung lesions. Ultrasonography can reveal the cause of white hemithorax differentiating pleural effusion from large tumor mass or atelectasis. Peripheral pulmonary lesions, extending into visceral pleura can be visualized by ultrasonography and differentiation solid tumor from inflammation is possible. Mediastinal lesions. Computerized tomography and magnetic resonance are methods of choice in diagnosing mediastinal diseases. Ultrasonography is useful in distinguishing normal thymus from tumor mass and for ultras onographyguided biopsy. Conclusion. Ultrasonography is a very useful second line method in diagnosis of chest disease. The advantages of this method include bed side availability, absence of radiation, and guided aspiration of fluid-filled areas and solid tumors.

scholarly journals Medical thoracoscopy- an experience

2017 ◽  
Vol 5 (5) ◽  
pp. 2176
Author(s):  
Naveed Nazir Shah ◽  
Nazia Mehfooz ◽  
Syed Suraya Farooq ◽  
Khurshid A. Dar ◽  
. Shumayl ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Pleural Diseases ◽  
Medical College ◽  
Medical Thoracoscopy ◽  
Chest Disease ◽  
Disease Hospital ◽  
Exudative Pleural Effusion

Background: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases especially undiagnosed exudative pleural effusion. It is cost effective and safe. The diagnostic yield in undiagnosed pleural effusion is excellent.Methods: This prospective observational study was done in Government Chest Disease hospital of Government Medical College, Srinagar during the period between December 2015 to Dec 2016.Thirty undiagnosed pleural effusion patients after thoracocentesis and who fulfilled inclusion and exclusion criteria’s were included in the study. Medical thoracoscopy using rigid thoracoscope was started for the first time in our hospital and was done in these enrolled patients. Clinical, Thoracoscopic findings and histopathological data of the patients were collected prospectively and analysed.Results: Maximum patients were in the age group of 41-50 years. Most common Thoracoscopic finding was multiple nodules (40%) followed by sago grain infiltration (33.4%). Malignancy was the most common HPE finding of pleural biopsy (46.6%) followed by TB (33.3%). All nodules (13) turned out to be malignant while all sago grain appearance pleura (10) turned out of to be TB. The overall diagnostic yield is 80% as a whole and 96% among patients who had thoracoscopic pleural findings.Conclusions: Medical Thoracoscopy is a safe and easy outpatient procedure and an excellent diagnostic tool for undiagnosed exudative pleural effusion. The diagnostic yield is quite high and complications of procedure are negligible.

scholarly journals Wegener Granulomatosis Revealed by Pleural Effusion

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Anne-Claire Toffart ◽  
François Arbib ◽  
Sylvie Lantuejoul ◽  
Jean-François Roux ◽  
Vincent Bland ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Clinical Manifestation ◽  
Lung Biopsy ◽  
Open Lung Biopsy ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Pleural Biopsy ◽  
Wegener Granulomatosis ◽  
Pleural Thickening ◽  
Open Lung ◽  
Granulomatous Vasculitis

Pulmonary signs are common in Wegener's granulomatosis (WG). However, an initial presentation including pleural effusion has not been described. We describe a case of WG in which pleural effusion was the first clinical manifestation. A 45-year-old man with dorsal pain presented with pleural thickening and effusion, and a visible nodule on a thoracic scan. A dense chronic inflammatory infiltrate was obtained by pleural biopsy and an open lung biopsy revealed necrotizing granulomatous vasculitis. Serologies were positive for antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies. A diagnosis of WG was conducted and the patient was started on cyclophosphamide and methylprednisolone as an initial treatment, with a favorable evolution. Although pleural effusion is rarely described in WG, this pathology must be considered in the presence of this clinical manifestation.

scholarly journals Differentiating transudative and exudative pleural effusion by pleural fluid cholesterol

2019 ◽  
Vol 1 (1) ◽  
pp. 5-8
Author(s):  
Ayyali Ambresh ◽  
Mallanna S Mulimani
Keyword(s):  
Pleural Effusion ◽  
Blood Sample ◽  
Pleural Fluid ◽  
Correct Diagnosis ◽  
Cost Effective ◽  
Underlying Disease ◽  
Diagnostic Value ◽  
Pleural Effusions ◽  
Biochemical Tests ◽  
Cross Sectional

Background: Pleural effusion is one of the common condition encountered in day to day practise. Pleural effusions represent a very common diagnostic task to the physician. A correct diagnosis of the underlying disease is essential to rational management. Today there are a number of laboratory tests available to differentiate exudates and transudates which are considered cost effective to the patients, so this study was designed for the measurement of pleural fluid cholesterol to differentiate transudative and exudative pleural effusions (sensitivity-97.8%, specificity-100%) with the advantage that a contemporary blood sample is not required, thereby lowering cost of diagnostic procedure. Objectives: To study the diagnostic value of Pleural fluid Cholesterol in differentiating transudative and exudative pleural effusions. Methodology: This cross sectional descriptive study was conducted on patients of pleural effusion (n=60)age >18 years patients with definitive clinical diagnosis and evidenced by radiological diagnosis of pleural effusion were taken as inclusion criteria. Results: The results showed majority of the patients were males (63.3%) and females (36.7%). According to lights criteria 46 patients were exudates and 14 patients were transudates and according to Pleural fluid Cholesterol criteria 45 patients were exudates and 15 patients were transudates with sensitivity of 97.8% and specificity of 100% and accuracy of 98.3%.Conclusion: The pleural fluid cholesterol criteria were found to be the most efficient criteria. Since this parameter involves the measurement of only pleural fluid values of cholesterol, it has following advantages-Economically it reduces number of biochemical tests and Simpler as there is no need to take simultaneous blood sample at the time of thoracocentesis.

scholarly journals Genotyping Strategies Using ddRAD Sequencing in Farmed Arctic Charr (Salvelinus alpinus)

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 899
Author(s):  
Fotis Pappas ◽  
Christos Palaiokostas
Keyword(s):  
Genetic Diversity ◽  
Salvelinus Alpinus ◽  
Arctic Charr ◽  
Cost Effective ◽  
Limiting Factors ◽  
Phenotypic Traits ◽  
Production Volume ◽  
High Coverage ◽  
Genomic Relationships ◽  
Low Coverage

Incorporation of genomic technologies into fish breeding programs is a modern reality, promising substantial advances regarding the accuracy of selection, monitoring the genetic diversity and pedigree record verification. Single nucleotide polymorphism (SNP) arrays are the most commonly used genomic tool, but the investments required make them unsustainable for emerging species, such as Arctic charr (Salvelinus alpinus), where production volume is low. The requirement to genotype a large number of animals for breeding practices necessitates cost effective genotyping approaches. In the current study, we used double digest restriction site-associated DNA (ddRAD) sequencing of either high or low coverage to genotype Arctic charr from the Swedish national breeding program and performed analytical procedures to assess their utility in a range of tasks. SNPs were identified and used for deciphering the genetic structure of the studied population, estimating genomic relationships and implementing an association study for growth-related traits. Missing information and underestimation of heterozygosity in the low coverage set were limiting factors in genetic diversity and genomic relationship analyses, where high coverage performed notably better. On the other hand, the high coverage dataset proved to be valuable when it comes to identifying loci that are associated with phenotypic traits of interest. In general, both genotyping strategies offer sustainable alternatives to hybridization-based genotyping platforms and show potential for applications in aquaculture selective breeding.

scholarly journals An intrasellar germinoma with normal tumor marker concentrations mimicking primary lymphocytic hypophysitis

2013 ◽  
Vol 57 (7) ◽  
pp. 566-570 ◽  
Author(s):  
Mariana F. Guzzo ◽  
Cristina B. Formiga Bueno ◽  
Thiago T. Amancio ◽  
Sergio Rosemberg ◽  
Cleonice Bueno ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Correct Diagnosis ◽  
Careful Analysis ◽  
Malignant Neoplasms ◽  
Pituitary Hormone ◽  
Appropriate Treatment ◽  
Suprasellar Region ◽  
Neoplastic Lesions ◽  
Posterior Pituitary Hormone ◽  
Pituitary Stalk Thickening

Intracranial germinomas (GE) are malignant neoplasms most commonly found in the suprasellar region, which may cause anterior and particularly posterior pituitary hormone deficits with central diabetes insipidus (DI). Differential diagnosis of pituitary stalk thickening includes granulomatous, inflammatory, infectious, and neoplastic lesions. Although careful analysis of clinical, laboratory, and imaging findings may facilitate the diagnosis, transsphenoidal biopsy is indicated to confirm the disease, as the correct diagnosis directs the appropriate treatment.

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