66 patients with pleural cancers (40 males, 26 females) were treated at Bach Mai hospital from 1996 to 2000. Pleural cancer was rare and concentrating at the age group > 40, more common in male than in female. 70% of pleural cancer patient had got a history of chronical pleural inflammation. The common symptoms were chest pain, cough, dyspnoea, syndrome of “3 reduces”. Among these 66 patients, some could get secondary pleural cancer caused the metastasis and invasion from other organs. None case was consistent with previous diagnosis from lower health care service level.
Diagnosis ; Pleural Neoplasms ; Carcinoma ; Epidemiology

Humans ; Mesothelioma/pathology* ; Mesothelioma, Malignant ; Pleural Neoplasms/diagnosis* ; Pleural Effusion, Malignant ; Pleural Effusion/pathology*

BACKGROUND: Pleural effusion is a common clinical problem and many clinical and laboratory evaluations, such as tumor marks, have been studied to discriminate malignant pleural fluid from benign pleural fluid. However their usefulness in the diagnosis of pleural effusion is still not established fully. We studied the diagnostic value of cyfra 21-1 in diagnosis of malignant pleural effusion. METHODS: Pleural fluid was obtained from 45 patients with malignant diseases(32 lung cancer patients, 13 metastatic malignant diseases) and 47 patients with benign diseases. The level of cyfra 21-1 in the pleural fluid and serum were determined using a CYFRA 21-1 enzyme immunoassay kit(Cis-Bio International Co.). The t-test was used for comparison between two diseases groups and receiver operating characteristic(ROC) curves were constructed by calculating the sensitivities and specificities of the cyfra 21-1 at several points to determine the diagnostic accuracy of the cyfra 21-1. RESULTS: In patients with primary lung cancer, the level of cyfra 21-1 in the pleural fluid was significantly higher than those of patients with benign diseases and had positive correlations between the level of cyfra 21-1 in the pleural fluid and serum levels. In the ROC curve analysis of the pleural fluid, the curve for primary lung cancer group was located closer to the left upper corner and the cut off value, sensitivity and specificity of the cyfra 21-1 of the primary lung cancer group was determined as 22.25ng/ml, 81.8% and 78.7% respectively. CONCLUSIONS: Our data indicates that the measurement of cyfra 21-1 level in pleural effusion has useful diagnostic value to discriminate malignant pleural effusion in primary lung cancer from benign pleural effusion.
Diagnosis ; Diagnosis, Differential* ; Humans ; Immunoenzyme Techniques ; Lung Neoplasms ; Pleural Effusion* ; Pleural Effusion, Malignant ; ROC Curve

A 44-year-old man was transferred to our department for mediastinal mass. He had suffered from only an easily fatiguable condition for 1 month. A physical examination and laboratory finding of the patient disclosed no abnormality. A chest radiograph showed a soft tissue tumor in the posterior mediastinum. It was well circumscribed and ovoid. Invasions to adjacent organs were not seen. Therefore it was though the 5th intercostal space. The tumor mass was attached to the visceral pleura of the right upper lobe by a pedicle and this pedunculated tumor laid entirely within the pleural cavity. Excision of the tumor which measured 7x7x3cm was done easily. Pathologic studies confirmed the diagnosis of localized fibrous tumor of the pleura. Localized fibrous tumor of the pleura is rare, This tumor along ith the evidence from ultrastructural and immunohistochemical studies has led most researchers to conclude that localized fibrous tumor is not of the mesothelial origin but arises in the submesothelial connective tissue.
Adult ; Connective Tissue ; Diagnosis ; Humans ; Mediastinum ; Mesothelioma ; Physical Examination ; Pleura* ; Pleural Cavity ; Pleural Neoplasms ; Radiography, Thoracic

Malignant pleural effusion (MPE) can occur in nearly all types of malignant tumors, with lung cancer being the most prevalent cause. The presence of MPE indicates an advanced stage or distant spread of the tumor, significantly reducing the patient's life expectancy. Particularly, a substantial amount of pleural effusion can impede heart and lung function, impair blood oxygen perfusion levels in the body, and greatly diminish patients' quality of life. Even when systemic treatment has alleviated the primary lung tumor in some patients, effective control over MPE remains challenging and impacts clinical outcomes. Therefore, it is crucial to implement measures for reducing or managing MPE while ensuring standardized treatment for lung cancer. In recent years, significant advancements have been made in diagnosing and treating lung cancer complicated by MPE through extensive basic and clinical research. Based on existing evidence and China's clinical practice experience, relevant experts from the China Association of Health Promotion and Education and Cancer Rehabilitation and Palliative Treatment Professional Committee of China Anti-Cancer Association (CRPC) have summarized key aspects related to diagnosis and treatment consensus opinions for lung cancer complicated by MPE. This aims to establish standardized procedures that will serve as a reference for doctors' clinical practice.
Humans ; Lung Neoplasms/diagnosis* ; Pleural Effusion, Malignant/therapy* ; Consensus ; Quality of Life ; Pleural Effusion/therapy*

A prospective study was performed on 50 in-patients (62% male, 38% female) with pleural effusion due to primary lung cancer and pleural cancer at Bach Mai Hospital from October 2002 to November 2003, mean age of 57.9  14.4 year old. In 70% of patients the disease developed for more than 4 weeks. Common clinical signs were chest pain 92%, dysapnea 68%, prolonged dry cough 52%, hemoptypsy 16%. The syndrome of 3 reduces occured in 100% of cases. Effusion on right side is 60% vs 30% on left side. In 4%, there was bilateral effusion. Cancer cells notified in 30% of pleural fluid, and in 58.1% of pleural biopsies
Diagnosis ; Tomography, X-Ray Computed ; Pleural Effusion ; Lung Neoplasms

The sex cord tumor with annular tubules(SCTAT) is a rare ovarian neoplasm, which charateristically shows simple and complex annular tubules with central acidophilic hyaline bodies. This tumor has been considered as a tumor of low-grade malignancy with late recurrence. We presented a brief case report of metastatic SCTAT of ovary in pleural fluid from ovary with cytopathologic and clinical features. The cytologic features of differential diagnosis are discussed.
Diagnosis, Differential ; Female ; Hyalin ; Ovarian Neoplasms ; Ovary ; Pleural Effusion* ; Recurrence

OBJECTIVETo discuss the clinical characteristics, diagnosis and treatment of the clinical characteristics and prognosis of asbestosis complicated with malignant mesothelioma patients.

METHODSIn 3 cases of asbestosis complicated with malignant mesothelioma were retrospectively analyzed.

RESULTSIn the 3 patients, 2 cases of pleural mesothelioma, with chest tightness, chest and back pain as initial symptom; 1 case of peritoneal mesothelioma, with abdominal distention, abdominal pain, dysuria as initial symptom. One case of the pleural mesothelioma misdiagnosed as tuberculous pleurisy. 3 patients were in CT or B ultrasound guided biopsy pathology confirmed to be malignant mesothelioma. 2 patients received systemic chemotherapy, another received symptomatic and supportive treatment. Up till now, 3 patients have died.

CONCLUSIONThe disease is a high degree of malignant, the early clinical manifestations are not specific, easily missed diagnosis and misdiagnosis. The treatment effect is not ideal, the prognosis is poor. Biopsy is a reliable method for diagnosis of MM.

Abdominal Pain ; Asbestosis ; complications ; diagnosis ; Back Pain ; Biopsy ; Diagnostic Errors ; Humans ; Lung Neoplasms ; complications ; diagnosis ; Mesothelioma ; complications ; diagnosis ; Peritoneal Neoplasms ; Pleural Neoplasms ; Prognosis ; Retrospective Studies ; Tuberculosis, Pleural

We present a case of a 47-year-old woman with benign solitary fibrous tumor of the pleura originated in the diaphragm which was discovered incidentally on a chest radiograph. Chest radiograph, sonograph, computed tomographic scan and magnetic resonance image studies proved a well circumscribed and lobulated fibrous tumor of the pleura. During the subsequent right thoracotomy, the tumor was found to be encapsulated and consisted of firm mass. It was connected to the diaphragm with 5x4 cm area by pedicle. Most of the tumor was free of adhesion. It was excised completely together with attached diaphragm. The tumor measured 23.5x3.5x8.0 cm and the pathologic diagnosis was benign solitary fibrous tumor and the attached diaphragm was free of disease.
Diagnosis ; Diaphragm ; Female ; Humans ; Middle Aged ; Pleura* ; Pleural Neoplasms ; Radiography, Thoracic ; Solitary Fibrous Tumor, Pleural ; Solitary Fibrous Tumors* ; Thoracotomy

BACKGROUND: The estimation of ADA activity in pleural fluid has been proved useful tool in the diagnosis of tuberculous pleural effusions. However, there is controversy about its usefulness when estimated in bronchial washing fluid in the patients with pulmonary tuberculosis. This study aims at evaluating the usefulness of measuring ADA activity in bronchial washing fluid of tuberculous patients as biochemical marker in the early diagnosis of the disease. METHODS: We examined the difference of ADA activity in bronchial washing fluid among the group I (tuberculosis group), group II (lung cancer group) and group III (control group). RESULTS: There was significantly higher bronchial washing fluid ADA level in tuberculosis group compared to the lung cancer and control groups(p<0.01). CONCLUSION: These results suggest that bronchial washing fluid ADA activities seem to be a useful tool in the diagnosis of pulmonary tuberculosis.
Adenosine Deaminase ; Biomarkers ; Diagnosis ; Early Diagnosis ; Humans ; Lung Neoplasms ; Pleural Effusion ; Tuberculosis ; Tuberculosis, Pulmonary*