P ulmonary Aliya N. Husain, M.D. IX. Pleural Lesions A.
Effusions and pleuritis: Cytologic examination of pleural fluid
can be extremely helpful. Inflammation can be characterized and
malignancy looked for. Culture is also invaluable. B.
Pneumothorax, hemothorax and chylothorax:Cytologic examination
and cultures need to be done. C. Mesothelial plaques:These are
fibrous plaques and nodules on pleura associated with asbestos
exposure. Their presence, by itself, does not predispose to
malignant mesothelioma or asbestos-related lung disease. D.
Solitary, fibrous tumor:Previously known as localized pleural
mesothelioma, solitary fibrous tumor of the pleura is a sessile
or pedunculated mass, ranging in size from 1 to 36 cm.
Microscopically, these are composed of bundles of bland spindle
cells with elongated nuclei. The histogenesis of SFTs is
controversial. Immunocytochemical and ultrastructural studies
favour fibroblastic differentiation. Approximately 30% of SFTs
are malignant with local invasion, recurrence and