Fibrosing pleuritis

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.

Clinical:

• Pleural thickening on imaging.
• Pleural effusion.

Gross

• Pleural thickening associated with a pleural effusion.

Microscopic

Features:^{[citation needed]}

• Fibrosis.
  • Spindle cells.
  • Moderate cellularity.
• No necrosis.
• Inflammation - lymphocytes.

DDx:

• Mesothelioma, desmoplastic.
• Pleural plaques.
• Empyema with fibrosis.^{[citation needed]}

IHC

• p53 -ve/+ve.
  • More common in mesothelioma.

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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

• Medical lung diseases.