초록접수 현황
| 14F-234 | 포럼 발표 |
Tumor-like Conditions of the Pleura in Two Different Cases
Choi HahngJoon, Cho DeogGon, Chang YongJIn, Cho KyuDo
Department of Thoracic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea
Background : Tumor-like conditions of the pleura are any non-neoplastic lesions of the pleura itself, or within the pleural space, that resembles a tumor. They are rare, but sometimes can be originated by foreign materials through diverse route. These conditions are needed to be differentiated from those of tumors. Diagnosis is facilitated by recognizing certain imaging patterns and interpreting them in the clinical context. Their pathologic confirmation can be made by VATS biopsy.
Methods : A 33-years male patient without any special medical history went to hospital as he had left flank pain. He worked at a powdered-milk company. With the suspicion of ureter stone, abdomen CT was performed, and bilateral pleural mass was observed accidently. Chest CT was performed, and as a result, it was suspicious that he had asbestos related pleural plaques. For diagnosis, pleural biopsy was carried out.
A 52-years female patient without any special medical history went to hospital as she had a chest pain on the right side which first occurred two months ago. She underwent bilateral augmentation mammoplasty using collagen injection seven years ago. In the image of the chest CT, extensive nodular thickening of right pleura were observed. To distinguish between pleural malignancy like mesothelioma and granulomas associated with foreign body injection, we performed pleural biopsy.
Results : The male had operation by single-port VATS. In 4~8th posterolateral ribs, white color and hard plaque was observed. Something unusual was not observed in visceral pleura or lung parenchyme. Histopathologic examination revealed that it was ‘dense hyalinized fibrosis with focal chronic inflammatory cell infiltrate.’
The female had two-port VATS. In parietal pleura and visceral pleura, multiple nodularity was observed, and its size varied. And it was obviously marginated. It was observed that lung parenchyme was intact, and pleural effusion or adhesion was not observed. According to histopathologic diagnosis, it was `Chronic inflammation with foreign body reaction, degeneration and vacuolar space`, and it was suspicious that there was foreign body reaction induced by intrathoracic migration of collagen.
Conclusion : Although it may not be predicable in consideration of the male’s young age, it can be suspicious that he had asbestos-induced pleural plaque, given his likelihood of being exposed to asbestos on occupational account.
Augmentation mammoplasty using collagen injection is performed often for the cosmetic purpose. Intrathoracic migration of collagen is very rare, but it can occur more in the future. Taking detailed history of such operation can help diagnose other conditions from which pleural tumor is suspected.
It is judged that these cases can be used as a reference for a similar patient, and thus these cases and there operative findings are reported.
Methods : A 33-years male patient without any special medical history went to hospital as he had left flank pain. He worked at a powdered-milk company. With the suspicion of ureter stone, abdomen CT was performed, and bilateral pleural mass was observed accidently. Chest CT was performed, and as a result, it was suspicious that he had asbestos related pleural plaques. For diagnosis, pleural biopsy was carried out.
A 52-years female patient without any special medical history went to hospital as she had a chest pain on the right side which first occurred two months ago. She underwent bilateral augmentation mammoplasty using collagen injection seven years ago. In the image of the chest CT, extensive nodular thickening of right pleura were observed. To distinguish between pleural malignancy like mesothelioma and granulomas associated with foreign body injection, we performed pleural biopsy.
Results : The male had operation by single-port VATS. In 4~8th posterolateral ribs, white color and hard plaque was observed. Something unusual was not observed in visceral pleura or lung parenchyme. Histopathologic examination revealed that it was ‘dense hyalinized fibrosis with focal chronic inflammatory cell infiltrate.’
The female had two-port VATS. In parietal pleura and visceral pleura, multiple nodularity was observed, and its size varied. And it was obviously marginated. It was observed that lung parenchyme was intact, and pleural effusion or adhesion was not observed. According to histopathologic diagnosis, it was `Chronic inflammation with foreign body reaction, degeneration and vacuolar space`, and it was suspicious that there was foreign body reaction induced by intrathoracic migration of collagen.
Conclusion : Although it may not be predicable in consideration of the male’s young age, it can be suspicious that he had asbestos-induced pleural plaque, given his likelihood of being exposed to asbestos on occupational account.
Augmentation mammoplasty using collagen injection is performed often for the cosmetic purpose. Intrathoracic migration of collagen is very rare, but it can occur more in the future. Taking detailed history of such operation can help diagnose other conditions from which pleural tumor is suspected.
It is judged that these cases can be used as a reference for a similar patient, and thus these cases and there operative findings are reported.
책임저자: Cho DeogGon
Department of Thoracic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea
연락처 : Choi HahngJoon, Tel: 02-594-0174 , E-mail : chjbeatles@naver.com
