The Pleura. A mesothelial surface lining the lungs and mediastinum Mesothelial cells designed for fluid absorption Hallmark of disease is the effusion.

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Presentation transcript:

The Pleura

A mesothelial surface lining the lungs and mediastinum Mesothelial cells designed for fluid absorption Hallmark of disease is the effusion

Pleural Effusion Transudate (low protein)  cardiac failure  hypoproteinaemia Exudate (high protein)  pneumonia  TB  connective tissue disease  malignancy (primary or metastatic)

Purulent Effusion Full of acute inflammatory cells Empyema Can become chronic

Pneumothorax Air in pleural space Trauma Rupture of bulla

Large bullae

Pleural Neoplasia Primary  benign (rare)  malignant mesothelioma Secondary  common (adenocarcinomas - lung, GIT, ovary)

Mesothelioma

Pleural biopsy - mesothelioma Mixed spindle cell (mesenchymal) and epithelial differentiation

Metastases in Pleura

Differential diagnosis of malignant effusions….. Cytology, biopsy Difficult Immunohistochemistry for lineage specific antigens may help Medicolegal importance

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