What is a pleural effusion?
An excess of fluid in the pleural cavity
What is a hydrothorax? What can cause it?
Edema of the pericardium
- Increased Hydrostatic Pressure (CHF)
- Low Serum Protein (Nephrotic Syndrome, Cirrhosis, Starvation)
- Collagen Vascular Disease
What is a Pyothorax?
Turbid effusion containing many PMNs resulting from infection of the pleura
What is a hemothorax? What is it caused by?
Blood in the pleural cavity as a result of trauma or rupture of a vessel (aortic dissection, tuberculosis)
What is a chylothorax?
Accumulation of lipid rich fluid (chyle) in the pleural cavity due to lymphatic obstruction
What is the most striking Syx of pleuritis?
Sharp, stabbing chest pain on inspiration
A tumor removed from a patient's pericardium is shown below. It is whorled and has a tan cut surface. What is the Dx?
Pleural localized (solitary) fibrous tumor
The histologic section below is of a pleural localized fibrous tumor. Describe the histology. What is the tumor typically immunopositive for?
The histology is described as the "pattern-less pattern" containing disordered mixtures of fibroblast-like cells and connective tissue; CD34 and bcl-2
What is the median age of Localized Solitary Fibrous Tumor Dx?
A patient has a tumor excised from their pericardium. The tumor shows markers for carcinoembryonic antige, Leu-M1, B72.3 and BER-EP4. What is the Dx?
A tumor is excised from the pericardium and shows calretinin, WT-1 and D240 on IHC. The tumor is also positive for cytokeratin. Histological section shows biphasic pattern of epithelial and sarcomatous elements. What is the Dx? Which marker helps least with differentiating this tumor? What two cancers have this marker?
Pleural Malignant Mesothelioma; Cytokeratin because adenocarcinoma and PMM both have it.
What causes pleural malignant mesothelioma?
This lung is encased by a dense pleural tumor that extends along the interlobar fissures but does not involve the underlying lung parenchyma. It is described as having a pleural rind. What is the Dx?
Pleural malignant mesothelioma