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Rare Pleural Tumors Clinics in Chest Medicine

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1 Rare Pleural Tumors Clinics in Chest Medicine
Christopher T. Erb, MD, PhD, Kelsey M. Johnson, PA-C, Anthony W. Kim, MD  Clinics in Chest Medicine  Volume 34, Issue 1, Pages (March 2013) DOI: /j.ccm Copyright © 2013 Elsevier Inc. Terms and Conditions

2 Fig. 1 Diseases resembling primary pleural tumors on imaging. (A, B) Rounded atelectasis, (C) pleural plaques (arrows indicate several anterior pleural plaques with calcification), (D) extramedullary hematopoiesis, (E) loculated haemothorax (arrows indicate areas of increased attenuation within the loculation), and (F) metastases from other primary tumors. ([A, B] Courtesy of Cindy R. Miller, MD, Associate Professor of Diagnostic Radiology, Yale School of Medicine, New Haven, CT; [C] Adapted from Nishimura SL, Broaddus VC. Asbestos-induced pleural disease. Clin Chest Med 1998;19(2):311–29; [D] Courtesy of Christopher T. Erb, MD, PhD, New Haven, CT; [E, F] Adapted from McLoud TC. CT and MR in pleural disease. Clin Chest Med 1998;19(2):261–76.) Clinics in Chest Medicine  , DOI: ( /j.ccm ) Copyright © 2013 Elsevier Inc. Terms and Conditions

3 Fig. 2 Diagnostic approach to uncommon primary pleural tumors.
Clinics in Chest Medicine  , DOI: ( /j.ccm ) Copyright © 2013 Elsevier Inc. Terms and Conditions

4 Fig. 3 Representative images of rare pleural tumors. (A) SFTP, (B) calcifying fibrous tumor of the pleura (arrow indicates the interface between the tumor and the diaphragm on the right), (C) CT scan showing coronal view of subpleural lipoma (arrowhead shows the homogenous hypodense pleural-based mass), (D) pleural thymoma, (E) primitive neuroectodermal tumor, and (F) pleural lymphoma (arrows indicate the soft tissue mass along the pleura; arrowhead indicates rib involvement with bony destruction). ([A] From Foran P, Colleran G, Madewell J, et al. Imaging of thoracic sarcomas of the chest wall, pleura, and lung. Semin in Ultrasound, CT, and MRI 2011;32(5):365–76; with permission; [B] From Jang KS, Oh YH, Han HX, et al. Calcifying fibrous pseudotumor of the pleura. Ann Thorac Surg 2004;78(6):e87–8; with permission; [C] From Karlo CA, Stolzmann P, Frauenfelder T, et al. Computed tomography imaging of subpleural lipoma in two men: two case reports. J Med Case Rep 2010;4:380; [D] From Kim HS, Lee HJ, Cho SY, et al. Myasthenia gravis in ectopic thymoma presenting as pleural masses. Lung Cancer 2007;57(1):115–7; with permission; [E] Courtesy of Cindy R. Miller, MD, Associate Professor of Diagnostic Radiology, Yale School of Medicine, New Haven, CT; and [F] From Bae YA, Lee KS. Cross-sectional evaluation of thoracic lymphoma. Thorac Surg Clin 2010;20(1):175–86.) Clinics in Chest Medicine  , DOI: ( /j.ccm ) Copyright © 2013 Elsevier Inc. Terms and Conditions

5 Fig. 4 (A) Histology of malignant solitary fibrous tumor of the pleura (SFTP) showing hypercellularity with a high mitotic index. In the inset, the characteristic hemangiopericytomalike pattern of the neoplasm is observed. (B) Calcifying fibrous tumor histopathology (hematoxylin-eosin [H&E] staining). Typically a nodular lesion with dense hyalinized collagen intermixed with calcified bodies (arrowhead indicates a calcified body, which stains dark with H&E). (C) Adenomatoid tumor histopathology (H&E staining). Loose collagen bundles surround ringlike vascular channels and epithelial inclusions. (D) Chest wall Askin (PNET) tumor (H&E staining). (E) Malignant fibrous histiocytoma (H&E staining). (F) Malignant peripheral nerve sheath tumor (H&E staining). (From [A] Cardillo G, Carbone L, Carleo F, et al. Solitary fibrous tumors of the pleura: an analysis of 110 patients treated in a single institution. Ann Thoracic Surg 2009;88(5):1632–7; [B, C] English JC, Leslie KO. Pathology of the pleura. Clin Chest Med 2006;27(2):157–80; [D] Rais-Barhami S, Drabick JJ, De Marzo AM, et al, Xp11 translocation renal cell carcinoma: delayed but massive and lethal metastases of chemotherapy-associated secondary malignancy. Urology 2007;70(1):178.e3–6; and [E, F] Deniz K, Oban G, Okten T. Anti-CD10 [56C6] expression in soft tissue sarcomas. Pathol Res Pract 2012;208(5):281–5; with permission.) Clinics in Chest Medicine  , DOI: ( /j.ccm ) Copyright © 2013 Elsevier Inc. Terms and Conditions


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