Is the pathology related to the amount of pleural thickening measured by thorax CT?
Abstract
Background: Pathologies associated with pleural thickening are presented along with similar clinical and radiological findings. The present study highlights the importance of the differential diagnosis verification of patients with pleural thickening. Video-assisted thoracoscopic surgery (VATS) is one of the most common diagnostic and therapeutic method used for this purpose. In this study, we aim to deliver our clinical investigation results on patients diagnosed with pleural pathology in the light of recent literature.
Methods: During the period of May 2012-June 2014, single port VATS pleural biopsy were successfully performed on 40 patients (25 male and 15 female) in our hospital. Thoracic CT and pathology results were compared. Clinical diagnosis, radiologic findings, and biopsy results were evaluated retrospectively.
Results: The average age of the patients is 59.15 ±12.13 (age range 23, 82). There was an environmental exposure to asbestos in 14 patients (35%). 25 patients (62.5 %) was followed with clinical pre-diagnosis of mesothelioma, 8 patients (20%) of tuberculosis, 4 patients (10%) of pleural metastasis and 3 patients (7.5 %) of pleuritis. Histopathologically 8 patients (20%) were diagnosed with malignant mesothelioma, 1 patient (2.5 %) was localized fibrous tumor, 2 patients were (5%) diagnosed with reactive mesothelial hyperplasia, 6 patients (15%) were malignant epithelial tumor metastasis, 16 patients (40%) were fibrinous pleuritis, 6 patients (15%) were chronic granulomatous inflammation, and 1 patient (2.5%) was chronic lymphocytic inflammation.
Conclusions: The present study demonstrates insufficency of thoracic CT for diagnosis and differential diagnosis due to similar clinical and radiological findings associated with pathological pleural thickening. Histopathologic examination is required for diagnosis. However, thoracic CT is still a method of radiographic imaging that is actively used in determination of pleural biopsy position, evaluation, and clinical monitoring of response to treatment.Keywords
References
- References 1. Sugarbaker DJ, Bueno R, Krasna MJ, Mentzer SJ, Zellos L (eds). Adult Chest Surgery. New York: The McGraw-Hill Company, 2009.
- 2. Kaynak K. Plevra hastalıklarında torakoskopi(VATS) ve torakotomi. Solunum 2002;4(1): 116-21.
- 3. Caccavale RJ, Lewis RJ. Video-assisted thoracic surgery as a diagnostic tool. In: Shields TW, Lo Cicero III J, Ponn RB eds. General Thoracic Surgery 5th edition LWW 2000: Volume 1 Ch 18; 285-293.
- 4. Zielinski M, Hauer J, Hauer L et-al. Staging algorithm for diffuse malignant pleural mesothelioma. Interact Cardiovasc Thorac Surg. 2010;10 (2): 185-9.
- 5. Robins SL., Cotran RS. Pathologic Basis of Disease 7th edition 712-772.
- 6. Webb WR, Higgins CB. Thoracic İmaging. Pulmonary and Cardiovascular radiology. Lippincott Williams and Wilkins. 2011, pp 625-647.
- 7. Soomin Ahn, In Ho Choi and Myung-Ju Ahn. Pleural Mesothelioma: An Instıtutional Experience of 66 cases. Korean J Pathol, 2014 Apr; 48(2):91-99.
- 8. Okten F, Köksal D, Onal M, Ozcan A, Simşek C, Ertürk H. Computed tomography findings in 66 patients with malignant pleural mesothelioma due to environmental exposure to asbestos. ClinImaging. 2006 May-Jun;30(3):177-80.
Details
Primary Language
English
Subjects
Health Care Administration
Journal Section
Research Article
Authors
Özgür Katrancıoğlu
*
Department of Thoracic Surgery, Cumhuriyet University School of Medicine
Türkiye
Tuba Sahinoglu
Department of Thoracic Surgery, Sivas Numune State Hospital
Kayhan Karakus
Department of Radiology, Sivas Numune State Hospital
Ozan Kandemir
Department of Nuclear Medicine, Sivas Numune State Hospital
Semiha Urvay
Department of Oncology, Cumhuriyet University School of Medicine
Esra Aydın Karakaya
Department of Pathology, Sivas Numune State Hospital
Nurkay Katrancioglu
Department of Cardiovascular Surgery, Malatya Gözde Akademi Hospital
Publication Date
June 5, 2018
Submission Date
November 29, 2017
Acceptance Date
March 12, 2018
Published in Issue
Year 2018 Volume: 40 Number: 2