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Difference between revisions of "Fibrosing pleuritis"
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'''Fibrosing pleuritis''', also '''fibrous pleurisy''', is an uncommon benign condition that mimics [[malignant mesothelioma]]. | '''Fibrosing pleuritis''', also '''fibrous pleurisy''' and '''fibrous pleuritis''', is an uncommon benign condition that mimics [[malignant mesothelioma]]. | ||
It may be referred to as ''cryptogenic bilateral fibrosing pleuritis'', if it is bilateral. | It may be referred to as ''cryptogenic bilateral fibrosing pleuritis'', if it is bilateral. | ||
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==Gross== | ==Gross== | ||
*Pleural thickening associated with a pleural effusion. | *Pleural thickening associated with a [[pleural effusion]]. | ||
==Microscopic== | ==Microscopic== | ||
Features: | Features:{{fact}} | ||
*Fibrosis. | *Fibrosis. | ||
**Spindle cells. | **Spindle cells. | ||
**Moderate cellularity. | **Moderate cellularity. | ||
*No [[necrosis]]. | *No [[necrosis]].<ref name=pmid9704618/> | ||
*Inflammation - lymphocytes.<ref name=pmid3166932/> | *Inflammation - lymphocytes.<ref name=pmid3166932/> | ||
DDx:<ref name=pmid15559051>{{Cite journal | last1 = Corson | first1 = JM. | title = Pathology of mesothelioma. | journal = Thorac Surg Clin | volume = 14 | issue = 4 | pages = 447-60 | month = Nov | year = 2004 | doi = 10.1016/j.thorsurg.2004.06.007 | PMID = 15559051 }}</ref> | DDx:<ref name=pmid15559051>{{Cite journal | last1 = Corson | first1 = JM. | title = Pathology of mesothelioma. | journal = Thorac Surg Clin | volume = 14 | issue = 4 | pages = 447-60 | month = Nov | year = 2004 | doi = 10.1016/j.thorsurg.2004.06.007 | PMID = 15559051 }}</ref> | ||
*[[Mesothelioma]], desmoplastic. | *[[Mesothelioma]], desmoplastic. | ||
** | *[[Pleural plaques]]. | ||
*[[Empyema]] with fibrosis.<ref name=pmid6284084>{{Cite journal | last1 = McCabe | first1 = TA. | last2 = Rakowski | first2 = TA. | last3 = Argy | first3 = WP. | last4 = Reilly | first4 = MJ. | title = Fibrosing uremic pleuritis complicated by thoracic empyema. | journal = Arch Intern Med | volume = 142 | issue = 7 | pages = 1369-70 | month = Jul | year = 1982 | doi = | PMID = 6284084 }}</ref> | |||
==IHC== | |||
*p53 -ve/+ve. | |||
**More common in mesothelioma.<ref name=pmid9704618>{{Cite journal | last1 = Mangano | first1 = WE. | last2 = Cagle | first2 = PT. | last3 = Churg | first3 = A. | last4 = Vollmer | first4 = RT. | last5 = Roggli | first5 = VL. | title = The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: a histologic and immunohistochemical analysis of 31 cases including p53 immunostaining. | journal = Am J Clin Pathol | volume = 110 | issue = 2 | pages = 191-9 | month = Aug | year = 1998 | doi = | PMID = 9704618 }}</ref> | |||
==Sign out== | |||
<pre> | |||
Pleura, Left Lung, Biopsy: | |||
- Fibrous pleuritis/pleural plaque (fibrous tissue with mild chronic inflammation | |||
and calcifications). | |||
- NEGATIVE for evidence of malignancy. | |||
</pre> | |||
===Micro=== | |||
The sections show dense fibrous tissue with bland appearing fibroblasts and mild chronic inflammation. Large calcifications are present. Lung parenchyma is not seen. | |||
Nodular areas are not apparent. Concerning hypercellular areas are not seen. Necrosis is not present. Nuclear atypia is not identified. Mitotic activity is not readily apparent. | |||
==See also== | ==See also== | ||