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

Hepatobiliary cystadenomas are rare cystic neoplasms that often occur in middle aged women. The exact etiology of these tumors is unknown. Diagnosis is often delayed in these cases. However, misdiagnosis and inappropriate treatment may result in unfavorable outcome. We report a case of hepatobiliary cystadenoma with pleural effusion. We also review the literature and discuss the current diagnostic and treatment modalities.
Bile Duct Neoplasms ; diagnosis ; pathology ; Bile Ducts, Intrahepatic ; pathology ; Cystadenoma ; diagnosis ; pathology ; Female ; Humans ; Middle Aged ; Pleural Effusion ; diagnosis ; pathology

INTRODUCTIONThe aims of this study were to determine the distribution of transudates and exudates among pathologically proven malignant pleural effusions, and to demonstrate the necessity for cytologic studies in patients with a transudative effusion.

MATERIALS AND METHODSThis study is a retrospective review of all subjects diagnosed with malignant or paramalignant pleural effusion over a 10-year period at a tertiary hospital. The study included 67 subjects with malignant mesothelioma, 45 subjects with metastatic disease, and 36 subjects with paramalignant effusions.

RESULTSThere were 55 female and 93 male subjects; the mean age of the sample was 62 years. Malignant pleural effusions were transudative in 1.5% of malignant mesotheliomas, 6.8% of metastatic diseases, and 11.1% of paramalignant effusions.

CONCLUSIONSCytological examination of pleural fluid in patients with unexplained transudative effusion is essential to rule out malignant processes.

Cohort Studies ; Exudates and Transudates ; Female ; Humans ; Male ; Mesothelioma ; diagnosis ; pathology ; Middle Aged ; Pleural Effusion, Malignant ; pathology ; Pleural Neoplasms ; diagnosis ; pathology ; secondary ; Retrospective Studies

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm arising from the antigen-presenting cells of the immune system. This disease usually involves the lymph nodes, and rarely, extranodal sites may be affected. The authors report a case of extranodal IDCS presenting in the pleura. A 32-yr-old man presented with progressive chest pain. Imaging studies showed diffuse pleural thickening with pleural effusion. Morphological and immunohistochemical analysis of an incisional biopsy of the pleura were consistent with a diagnosis of IDCS; tumor cells were positive for S100 and CD45, but negative for CD1a, CD21, CD35, B cell and T cell markers. The patient was administered chemotherapy, but died of progressive disease. Although its incidence is extremely rare, this case suggests that extranodal IDCS should be considered in the differential diagnosis of undifferentiated neoplasms and that immunohistochemical staining be performed using appropriate markers.
Adult ; Dendritic Cell Sarcoma, Interdigitating/diagnosis/*pathology ; Fatal Outcome ; Humans ; Male ; Pleura/*pathology ; Pleural Neoplasms/diagnosis/*pathology ; Tumor Markers, Biological

OBJECTIVE: To evaluate the role of medical thoracoscopy in the diagnosis of the pleural effusion of unknown etiology. METHODS: The results of 36 patients with the pleural disease of unknown etiology diagnosed by medical thoracoscopy were retrospectively analyzed, including the pathologic results and the complications. RESULTS: Among the 36 patients, 35 were determined with positive rate of 97.2%, and no serious complications was found. CONCLUSION Medical thoracoscopy is an important method of diagnosing complicate pleural effusion, and has high positive rate. It is a simple operation, with no serious complication, and fast recovery.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pleural Effusion ; diagnosis ; pathology ; Pleural Neoplasms ; diagnosis ; pathology ; Retrospective Studies ; Sensitivity and Specificity ; Thoracoscopy

OBJECTIVETo evaluate the application of traditional cytomorphology, telomerase activity analysis and immunocytochemistry in cytopathologic diagnosis of pleural effusion and bronchoalveolar lavage samples.

METHODSA total of 123 agar-paraffin double-embedded pleural effusion and bronchoalveolar lavage fluid samples were enrolled into study. The cytomorphologic features were reviewed and correlated with immunocytochemical findings and telomerase activity.

RESULTSTelomerase activity was detected in 53 specimens using the real-time telomeric repeat amplification protocol. Amongst the cases studied, 39 samples (31.7%) contained overtly malignant cells while 20 cases (16.0%) were equivocal by conventional cytology. After verification by immunocytochemistry and clinical follow-up data, the diagnostic accuracy of telomerase activity and cytology was 87.0% and 82.1%, respectively. The sensitivity (97.6%) and specificity (100.0%) of cytology examination, when combined with telomerase activity analysis, were greater than those of cytology examination or telomerase activity analysis alone.

CONCLUSIONSTelomerase activity analysis can be used as an adjunctive investigative tool in cytology assessment of pleural effusion and bronchoalveolar lavage samples. The diagnostic accuracy can be further improved with the application of immunocytochemistry on agar-paraffin double-embedded cell block tissues.

Breast Neoplasms ; diagnosis ; enzymology ; pathology ; Bronchoalveolar Lavage Fluid ; chemistry ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; diagnosis ; enzymology ; pathology ; Pleural Effusion ; diagnosis ; enzymology ; pathology ; Pleural Effusion, Malignant ; diagnosis ; enzymology ; pathology ; Sensitivity and Specificity ; Telomerase ; metabolism

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

Humans ; Mesothelioma, Malignant/diagnosis* ; Diagnosis, Differential ; Adenocarcinoma/pathology* ; Mesothelioma/pathology* ; Lung Neoplasms/pathology* ; Biomarkers, Tumor ; Pleural Neoplasms/diagnosis* ; Extracellular Matrix Proteins

"Hyalinizing spindle cell tumor with giant rosettes" (HSCTGR) is a recently described tumor, which is regarded as an unusual variant of low-grade fibromyxoid sarcoma. Proof of a metastatic potential was lacking. The patient in the report was a 35-yr-old woman who showed multiple bilateral pulmonary nodules with massive pleural effusion in the right side. She had a history of a mass excision in the right thigh 11 yrs ago at another hospital, which was reported as a "leiomyoma". Two years before this presentation, the patient received a routine chest radiograph which demonstrated bilateral multiple pulmonary nodules. A lobectomy of the left upper lung was performed. The histological findings revealed a well-circumscribed nodule that was characterized by a spindle-shaped fibrous to hyalinized stroma with criss-crossing short fascicles and giant collagen rosettes surrounded by a rim of spindle-shaped cells. Electron microscopy confirmed the fibroblastic nature of the tumor. This case, in addition to at least two other cases reported in the literature, demonstrates that the HSCTGR is a malignant neoplasm with the capacity to metastasize after a long hiatus.
Adult ; Female ; Humans ; Hyalin/metabolism ; Korea ; Lung Neoplasms/diagnosis/*pathology/*secondary/ultrastructure ; *Neoplasm Metastasis ; Pleural Effusion/pathology ; Sarcoma/diagnosis/*pathology/ultrastructure ; Thigh/pathology ; Time Factors

Pleuropulmonary blastoma (PPB) is a rare dysontogenetic neoplasm in children and has been recognized as a distinct clinicopathological entity different from the ordinary pulmonary blastoma of adulthood. We report a very rare adult case of PPB. A 43-year-old female patient presented with massive pleural infusion, and a misdiagnosis of pleural tuberculosis (TB) was made on the basis of ultrasound scan and CT images, for which therapy with TB drugs was administered for 3 weeks. Subsequent operation and pathologic examination of the mass revealed a multicystic neoplasm consisting of malignant mesenchymal cells immunohistochemically positive for vimentin and actin. Local recurrence occurred in the left pleural 20 months after the surgical tumor resection and 4 cycles of adjuvant chemotherapy.
Adult ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; surgery ; Pleural Effusion ; diagnosis ; etiology ; Pulmonary Blastoma ; diagnosis ; pathology ; surgery ; Tomography, X-Ray Computed