OBJECTIVE: To determine which computed tomography (CT) imaging features predict pleural malignancy in patients with advanced epithelial ovarian carcinoma (EOC) using video-assisted thoracic surgery (VATS), pathology, and cytology findings as the reference standard. METHODS: This retrospective study included 44 patients with International Federation of Obstetrics and Gynecology (FIGO) stage III or IV primary or recurrent EOC who had chest CT < or =30 days before VATS. Two radiologists independently reviewed the CT studies and recorded the presence and size of pleural effusions and of ascites; pleural nodules, thickening, enhancement, subdiaphragmatic tumour deposits and supradiaphragmatic, mediastinal, hilar, and retroperitoneal adenopathy; and peritoneal seeding. VATS, pathology, and cytology findings constituted the reference standard. RESULTS: In 26/44 (59%) patients, pleural biopsies were malignant. Only the size of left-sided pleural effusion (reader 1: rho=-0.39, p=0.01; reader 2: rho=-0.37, p=0.01) and presence of ascites (reader 1: rho=-0.33, p=0.03; reader 2: rho=-0.35, p=0.03) were significantly associated with solid pleural metastasis. Pleural fluid cytology was malignant in 26/35 (74%) patients. Only the presence (p=0.03 for both readers) and size (reader 1: rho=0.34, p=0.04; reader 2: rho=0.33, p=0.06) of right-sided pleural effusion were associated with malignant pleural effusion. Interobserver agreement was substantial (kappa=0.78) for effusion size and moderate (kappa=0.46) for presence of solid pleural disease. No other CT features were associated with malignancy at biopsy or cytology. CONCLUSION: In patients with advanced EOC, ascites and left-sided pleural effusion size were associated with solid pleural metastasis, while the presence and size of right-sided effusion were associated with malignant pleural effusion. No other CT features evaluated were associated with pleural malignancy.
Ascites ; Biopsy ; Gynecology ; Humans ; Neoplasm Metastasis ; Obstetrics ; Ovarian Neoplasms ; Pleural Diseases ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleural Neoplasms ; Retrospective Studies ; Seeds ; Thoracic Surgery, Video-Assisted ; Thorax

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

Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Pleural Cavity ; pathology

Anaplastic Lymphoma Kinase ; Humans ; Lung/pathology* ; Lung Neoplasms/pathology* ; Mesothelioma/surgery* ; Mesothelioma, Malignant ; Pleural Neoplasms/surgery*

A right pleural mass was detected incidentally in a 52-year-old woman and chest computed tomography showed lobulated pleural mass. Thoracoscopic excision was performed. Histology showed solitary fibrous tumor with extensive cystic change. Solitary fibrous tumor with extensive cystic change is very rare and we treated this tumor successfully with video-assisted thoracic surgery.
Female ; Humans ; Middle Aged ; Pleural Neoplasms ; Pneumothorax ; Solitary Fibrous Tumor, Pleural* ; Solitary Fibrous Tumors* ; Thoracic Surgery, Video-Assisted ; Thorax

BACKGROUND AND OBJECTIVEPleuropulmonary blastoma (PPB) is a rare malignant tumor with unique clinicopathological features. The aim of this study is to investigate the clinicopathological features, the diagnosis and differential diagnosis of pleuropulmonary blastoma.

METHODSFive cases of PPB were analyzed by light microscopy, immunohistochemistry and their clinical data, and the relative literatures were reviewed.

RESULTSFive cases of patients suffered from PPB were aged from 21 to 47 months (mean 32.8 months). Most of the masses were located in the thoracic cavities and 4 cases accompanied with pleural effusions. Histologically, these tumors included 1 case of type I PPB which showed pure cystic architecture; 2 cases were type II PPB which showed cystic and solid masses accompanied with rhabdomyoblastic differentiation and nodules of cartilage; the other 2 cases were type III PPB and characterized by absolute solid masses with anaplastic undifferentiated sarcomatous components. Immunohistochemical studies showed that tumor cells were positive for Vimentin and some for Desmin and Myogenin, the nodules of cartilage were positive for S-100. The tumor cells were negative for PCK, EMA and CD99.

CONCLUSIONPleuropulmonary blastoma is a rare and highly aggressive malignancy arising in the lung and pleural of infancy and early childhood. The type I, II and III PPB have unique clinicopathological features respectively. This kind of tumor should be distinguished from some benign and malignant diseases such as congenital cystic adenomatoid malformation (CCAM) and embryonal rhabdomyosarcoma.

Adult ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Middle Aged ; Pleural Neoplasms ; mortality ; pathology ; surgery ; Pulmonary Blastoma ; mortality ; pathology ; surgery

Video-assisted thoracic surgery (VATS) has developed very rapidly in these two decades, and has replaced conventional open thoracotomy as a standard procedure for some simple thoracic operations as well as an option or a complementary procedure for some other more complex operations. In this paper we will review its development history, the present status and the future perspectives.
Empyema ; surgery ; Esophageal Diseases ; surgery ; Esophagus ; pathology ; Humans ; Lung Neoplasms ; surgery ; Mediastinal Diseases ; surgery ; Pleural Effusion ; surgery ; Pneumothorax ; surgery ; Thoracic Surgery, Video-Assisted ; methods ; trends

Carcinoma, Squamous Cell ; complications ; diagnosis ; surgery ; Humans ; Lung Neoplasms ; complications ; diagnosis ; surgery ; Male ; Middle Aged ; Tuberculosis, Pleural ; complications ; diagnosis ; surgery

The progression to minimally invasive techniques has been almost a natural evolution of the use of video-assisted thoracic surgery (VATS) from the investigation of pleural diseases, such as pneumothorax, and pleural effusion. Surgical resection is the primary treatment for early-stage non-small cell lung cancer (NSCLC). Minimally invasive thoracic surgery has been extensively used in the field of lung cancer. As the procedure has evolved and been studied, thoracoscopic lobectomy has been demonstrated to be a safe and oncologically effective strategy in the surgical management of patients with early stage NSCLC. VATS is a minimally invasive technique that has many advantages in postoperative pain and recovery time. Most surgeons perform VATS for lung cancer with three or more incisions. As the technique of VATS has evolved, single- or double-port VATS for lung cancer has been recently attempted and its advantages have been reported.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms* ; Lung* ; Pain, Postoperative ; Pleural Diseases ; Pleural Effusion ; Pneumothorax ; Thoracic Surgery* ; Thoracic Surgery, Video-Assisted

It is very rare for an exocervical adenocarcinoma to metastasize to the lung parenchyma and pleura. A 54-year-old woman was admitted with dyspnea and left pleural effusion on chest X-ray. She had a history of exocervical adenocarcinoma 3 years previously and was treated with hysterectomy, chemotherapy, and radiation therapy. Last year, she was diagnosed with a left vestibular schwannoma and underwent subtotal mass removal surgery. After admission, metastatic adenocarcinoma of the pleura was diagnosed by video-assisted thoracic surgery biopsy. We herein report the rare case of exocervical adenocarcinoma that presented as a metastatic lesion to the pleura 3 years after the initial diagnosis.
Adenocarcinoma ; Biopsy ; Dyspnea ; Female ; Humans ; Hysterectomy ; Lung ; Middle Aged ; Neoplasm Metastasis ; Neuroma, Acoustic ; Pleura ; Pleural Effusion ; Pleural Neoplasms ; Recurrence ; Thoracic Surgery, Video-Assisted ; Thorax