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18 Cards in this Set
- Front
- Back
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what are the principal settings in which pleural effusions occur?
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VESSELS
increased hydrostatic pressure, eg CHF decreased oncotic pressure, eg nephrotic syndrome increased vascular permeability, eg pneumonia PLEURA increased intrapleural negative pressure, eg atelectasis LYMPHATICS decreased lymphatic drainage |
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what are the two broad categories of pleural effusion?
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inflammatory and non-inflammatory
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what are the types of inflammatory pleural effusions?
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serous, serofibrinous, fibrinous
purulent |
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what are the types of non-inflammatory pleural effusions?
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hydrothorax, most commonly secondary to CHF with pulmonary congestion
hemothorax chylothorax, most often caused by thoracic duct trauma or obstruction with secondary rupture of major lymphatic ducts |
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what is pneumothorax most commonly associated with?
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emphysema, asthma and tuberculosis
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what are the most frequent tumors of the pleura?
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secondary metastatic malignancies
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what are the most frequent metastatic malignancies of the pleura?
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primary neoplasms of lung and breast
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what type is the pleural effusion of malignancy?
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serous or serosanguinous
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what are the two major primary pleural tumors
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benign mesothelioma. aka solitary fibrous tumor
malignant mesothelioma |
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what are the findings in immunostaining of "benign mesothelioma"?
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CD34+, keratin negative
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what are gross features of malignant mesothelioma?
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extensive pleural effusion and direct invastion of thoracic structures
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what are the histologic types seen in malignant mesothelioma?
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60% epitheloid
20% sarcomatoid 20% mixed |
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what are histologic features of epitheloid malignant mesothelioma?
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tubular or papillary structures resembling adenocarcinoma, but staining is strong for keratin protein and various cytokeratin (CK), calretinin and WT-1 (Wilms tumor 1)
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what are histologic features of mesenchymal malignant mesothelioma?
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appears as spindle cell sarcoma
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what are clinical features of malignant mesothelioma?
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pulmonary asbestosis (fibrosis) is present in only 20% of individuals with malignant mesothelioma
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what are other sites where mesotheliomas can arise?
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peritoneum, pericardium, tunica vaginalis and genital tract (benign adenomatoid tumor)
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which extrapleural mesothelioma is particulary related to asbestos exposure?
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peritoneal mesotheliomas with 50% of patients having pulmonary fibrosis
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of what cell type origin are malignant and benign mesothelioma?
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malignant mesothelioma stems from mesenchymal cells, benign mesothelioma (aka solitary fibrous tumor) does not
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