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Tumours of the
Pleura |
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The most common tumour of the pleura is
metastatic carcinoma.
Metastatic tumours are the most common cause of neoplasm in
the pleura.
The most frequent primary sites are lung and breast,
causing pleural effusion.
Metastasis to the pleura is usually associated with a high-protein
exudate. Diagnosis can be made by cytology of aspirated fluid
or by needle biopsy of the pleura.
Primary neoplasms of the pleura are rare except after exposure
to asbestos, when tumours termed 'malignant mesotheliomas'
develop. After exposure, there may be a latent period of up to
50 years before development of the tumour.
Patients have chest pain and breathlessness, and there is commonly
a pleural effusion. Diagnosis is made on pleural biopsy.
Histologically, mesotheliomas have spindle cells and glandular patterns.
These are highly malignant tumours that spread around the
pleural cavity and pericardium, encasing the lung and
mediastinal structures. Death is usual
within ten months of diagnosis, and metastasis is rare.
Exposure to asbestos also causes development of benign collagenous
thickenings of the pleura, termed pleural plaques.
Mesothelioma is seen as a thick sheet of white tumour,
which encases the whole of the lung. |
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