No abstract available.
Lipoma* ; Pleura ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted*

Localized fibrous tumor of the pleura is a rare condition. Most follow a benign course and they are found as an incidental finding during routine chest X-ray. A small proportion of these tumors are malignant and have characteristic clinical and histopathological features. In this paper, we report three cases of localized fibrous tumors of the pleura, one malignant associated with asymptomatic hypoglycemia, the others benign. In a malignant case, the tumor was resected through thoracotomy and the hypoglycemia was relieved immediately. In two benign cases, tumors on small pedicles were resected using video-assisted thoracic surgical technique.
Hypoglycemia ; Incidental Findings ; Pleura* ; Pleural Neoplasms ; Thoracic Surgery ; Thoracotomy ; Thorax

Cardio-pulmonary responses to a given step-up exercise test were studied in 43 patients who previously received various thoracic operations such as pleural decortication, one or two segmental resections, right or left upper lobectomy, plombage or pneumonectomy. Fourteen control subjects were also studied for comparison. Following a 30 minute rest, the step-up exercise was performed to heights of 20, 30 and 40cm, in that order, for 8 to 10 min. at each height. During the rest and the steady-state exercise period, the expired gas was collected for a period of 5 minutes for the determinations of the minute volume, the O2 consumption and the CO2 Output. Alveolar gas samples were a1so taken following the expired gas collection. The heart rate and blood pressure were also checked during the rest and immediately after each exercise. Various cardio-pulmonary functions of the patient at rest were little different from those of the control, except the heart rate which tended to be higher in the patient than in the control. Although the work capacity of the patient was lower than in the control, most patients were able to complete the required exercise test. However, in carrying out a given exercise load, the patient groups had a greater minute volume, the respiratory rate, the O2 consumption and the CO2 output as compared to the control, indicating that the mechanical efficiency is considerably lowered in the patient. Of various patient groups, the work performance was most limited in the pneumonectomy group while the group with one or two segmental resections was little affected. It is suggested that the patient with one or two segmental resections may be allowed to engage in physical activity up to 700 kg-m/min or more while those with pneumonectomy should not exert themselves above 500 k-gm/min.
Adult ; *Exercise Test ; *Heart Function Tests ; Human ; Male ; Pleura/*surgery ; *Pneumonectomy ; *Respiratory Function Tests

Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.
Fascia ; Hematoma ; Hemothorax ; Pleura ; Pleural Cavity ; Thoracic Surgery, Video-Assisted ; Thoracic Wall ; Thoracoscopy ; United Nations

Intraoperative pleural lavage cytology is a diagnostic technique used to detect tumor cells and serve as a prognostic parameter for non-small cell lung cancer (NSCLC) patients. In the past several decades, many scholars have been dedicated to clarifying the relationships between positive intraoperative pleural lavage cytology results and postoperative survival as well as tumor recurrence and metastasis. However, the findings remained various due to the inhomogeneity of different research. It has been confirmed that a positive intraoperative pleural lavage cytology result is one of the risk factors for the prognosis of postoperative patients. This study reviewed the advances in research of intraoperative pleural lavage cytology in recent years from several aspects, including clinical significance, influencing factors and possible mechanisms.
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Cytological Techniques ; methods ; Humans ; Intraoperative Period ; Lung Neoplasms ; pathology ; surgery ; Pleura ; pathology

OBJECTIVE: To evaluate the therapeutic effect of remaining integrated mediastinal pleura upon the aortic arch and performing the anastomosis at the left cervix in radical operation for esophageal carcinoma. METHODS: Ninety-eight patients with esophageal carcinoma were treated with the operation mentioned above. Among them, 56 patients had cancer in the middle, 12 in the upper-middle, 24 in the lower-middle segments, and 6 had double-primary tumors, with carcinoma length of (5.2+/- 2.4) cm. The TNM stages were 6 of Stage I and 92 of Stages II-III. All cases were squamous cell carcinomas. RESULTS: All patients had satisfactory operation processes, without perioperative death, chylothorax, dyspnea, gastric retention, incision infection, and severe gastro-esophageal reflux. The life quality of the patients was improved. CONCLUSION The radical operation with remaining integrated mediastimal pleura upon the aortic arch and anastomosis at the cervix for treating esophageal carcinomas is of minimal invasion with fewer complications, and may be used in clinical practice.
Aged ; Anastomosis, Surgical ; methods ; Aorta, Thoracic ; surgery ; Carcinoma, Squamous Cell ; surgery ; Esophageal Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pleura ; surgery ; Thoracic Surgical Procedures ; methods

Lipoma is a common benign neoplasm, but lipoma arising from the pleura is rare. Most pleural lipomas are asymptomatic and are discovered incidentally on chest radiographs. Here we report an unusual case of a pedunculated subpleural lipoma with incomplete torsion in a 29-year-old woman who presented with flank pain. On chest radiography, there was a well-defined, ellipsoidal, homogeneous, radioopaque mass in the left lower lobe. An intrathoracic tumor was suspected, and video-assisted thoracic surgery was performed to establish the final diagnosis. The resected tumor was a 10 X 5 cm sized pedunculated pleural mass. The cut surface showed a yellow, well-circumscribed mass with areas of hemorrhage. Histologically, the tumor was composed of mature adipose tissue with fibrous septae composed of fibroblasts. The outer surface of the tumor was covered by mesothelial cells. Some areas were hypercellular, and occasional mitoses were found, but neither lipoblasts nor atypical mitoses were identified.
Adipose Tissue ; Adult ; Benzeneacetamides ; Female ; Fibroblasts ; Flank Pain ; Hemorrhage ; Humans ; Lipoma ; Mitosis ; Piperidones ; Pleura ; Thoracic Surgery, Video-Assisted ; Thorax

We present a rare case of a pleural loose body, thought to be a pedunculated pleural tumor, found incidentally in a 58-year-old female. Computed tomography showed a non-enhancing mass, which migrated along the mediastinum and paravertebral area. Thoracoscopic surgery revealed a 4 cm, soap-like mass that was found to be a fibrin body consisting of hyalinized collagen histopathologically. Mobility and the lack of contrast enhancement of a pleural mass are important clues to diagnosing this benign condition.
Diagnosis, Differential ; Female ; Fibrin/metabolism ; Humans ; Mediastinum ; Middle Aged ; Pleura/*pathology/surgery ; Pleural Neoplasms/diagnosis/pathology ; Tomography, X-Ray Computed

A 59-year old woman visited us for incidentally detected posterior mediastinal mass. Preoperative esophagography, esophagoscopy, esophageal ultrasound and computed tomography showed a esophageal submucosal tumor. With the diagonsis of esophageal leiomyoma, the patient underwent right side video-assisted thoracoscopic surgery (VATS): The mediastinal pleura and the esophageal muscle layers were longitudinally opened and the tumor was enucleated. Esophagography performed at 6th postoperative day revealed no esophageal mucosal bulging or leakage. The patient was discharged reveiving a soft diet on the 7th postoperative day. ha
Diet ; Esophageal Neoplasms ; Esophagoscopy ; Esophagus* ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Pleura ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Ultrasonography

BACKGROUND: Lung cancer is still the malignant tumor with the highest morbidity and mortality in China. Lung adenocarcinoma is the most common subtype, and the number of lung cancer presenting as mixed ground glass nodule (mGGN) in imaging is gradually increasing. Visceral pleural invasion (VPI) is an important factor affecting the prognosis of mGGN type lung adenocarcinoma. The aim of the study is to explore and analyze the risk factors for VPI in mGGN type lung adenocarcinoma. METHODS: From November 2016 to November 2019, 128 patients with mGGN lung adenocarcinoma underwent radical surgical resection in the First Affiliated Hospital of Nanjing Medical University. Their clinical data, including imaging, pathological and biological features, were collected and analyzed retrospectively. There were 40 males and 88 females, aged 60.3±9.3 years ranging from 30 to 81 years. Single factor Chi-square test and multivariate Logistic regression were used to analyze the risk factors of VPI in mGGN type lung adenocarcinoma. RESULTS: Among 128 mGGN patients who met the inclusion criteria, 57 cases were pathologically confirmed with pleural invasion. Between the VPI (+) and VPI (-) group (P<0.05), there were significant differences in gender, maximum diameter of solid component, consolidation tumor ratio (CTR), spicule sign, history of lung disease, family history of hypertension, relation of lesion to pleura (RLP), coursing relationship between bronchi and nodules. In multivariate Logistic regression analysis, RLP (OR=3.529, 95%CI: 1.430-8.713, P=0.006) and coursing relationship between bronchi and nodules (OR=3.993, 95%CI: 1.517-10.51, P=0.005) were found to be independent risk factors for VPI (P<0.05). CONCLUSIONS The possibility of VPI in m GGN lung adenocarcinoma should be evaluated by combining these parameters in clinical diagnosis and treatment. As independent risk factors, RLP and coursing relationship between bronchi and nodules are instructive to identify VPI in mGGN type lung adenocarcinoma.
Adenocarcinoma of Lung/pathology* ; Female ; Humans ; Lung Neoplasms/surgery* ; Male ; Neoplasm Invasiveness ; Pleura/pathology* ; Retrospective Studies ; Risk Factors