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== | ==IHC== | ||
*p53 -ve/+ve. | *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> | **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> | ||
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<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== | ||
Latest revision as of 12:35, 17 July 2017
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.
General
- Benign.
- No asbestos exposure.[1]
Clinical:[1]
- Pleural thickening on imaging.
- Pleural effusion.
Gross
- Pleural thickening associated with a pleural effusion.
Microscopic
Features:[citation needed]
DDx:[3]
- Mesothelioma, desmoplastic.
- Pleural plaques.
- Empyema with fibrosis.[4]
IHC
- p53 -ve/+ve.
- More common in mesothelioma.[2]
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Pleura, Left Lung, Biopsy: - Fibrous pleuritis/pleural plaque (fibrous tissue with mild chronic inflammation and calcifications). - NEGATIVE for evidence of malignancy.
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
References
- ↑ 1.0 1.1 1.2 Buchanan, DR.; Johnston, ID.; Kerr, IH.; Hetzel, MR.; Corrin, B.; Turner-Warwick, M. (Apr 1988). "Cryptogenic bilateral fibrosing pleuritis.". Br J Dis Chest 82 (2): 186-93. PMID 3166932.
- ↑ 2.0 2.1 Mangano, WE.; Cagle, PT.; Churg, A.; Vollmer, RT.; Roggli, VL. (Aug 1998). "The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: a histologic and immunohistochemical analysis of 31 cases including p53 immunostaining.". Am J Clin Pathol 110 (2): 191-9. PMID 9704618.
- ↑ Corson, JM. (Nov 2004). "Pathology of mesothelioma.". Thorac Surg Clin 14 (4): 447-60. doi:10.1016/j.thorsurg.2004.06.007. PMID 15559051.
- ↑ McCabe, TA.; Rakowski, TA.; Argy, WP.; Reilly, MJ. (Jul 1982). "Fibrosing uremic pleuritis complicated by thoracic empyema.". Arch Intern Med 142 (7): 1369-70. PMID 6284084.