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Stumpff JP, Kim SY, McFadden MI, Nishida A, Shirazi R, Steuerman Y, Gat-Viks I, Forero A, Nair MG, Morrison J. Pleural macrophages translocate to the lung during infection to promote improved influenza outcomes. Proc Natl Acad Sci U S A 2023; 120:e2300474120. [PMID: 38100417 PMCID: PMC10743374 DOI: 10.1073/pnas.2300474120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
Seasonal influenza results in 3 to 5 million cases of severe disease and 250,000 to 500,000 deaths annually. Macrophages have been implicated in both the resolution and progression of the disease, but the drivers of these outcomes are poorly understood. We probed mouse lung transcriptomic datasets using the Digital Cell Quantifier algorithm to predict immune cell subsets that correlated with mild or severe influenza A virus (IAV) infection outcomes. We identified a unique lung macrophage population that transcriptionally resembled small serosal cavity macrophages and whose presence correlated with mild disease. Until now, the study of serosal macrophage translocation in the context of viral infections has been neglected. Here, we show that pleural macrophages (PMs) migrate from the pleural cavity to the lung after infection with IAV. We found that the depletion of PMs increased morbidity and pulmonary inflammation. There were increased proinflammatory cytokines in the pleural cavity and an influx of neutrophils within the lung. Our results show that PMs are recruited to the lung during IAV infection and contribute to recovery from influenza. This study expands our knowledge of PM plasticity and identifies a source of lung macrophages independent of monocyte recruitment and local proliferation.
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Affiliation(s)
- James P. Stumpff
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA92521
| | - Sang Yong Kim
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA92521
| | - Matthew I. McFadden
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH43210
- Infectious Diseases Institute, The Ohio State University, Columbus, OH43210
| | - Andrew Nishida
- Department of Microbiology, University of Washington, Seattle, WA98109
| | - Roksana Shirazi
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA92521
| | - Yael Steuerman
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv6997801, Israel
| | - Irit Gat-Viks
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv6997801, Israel
| | - Adriana Forero
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH43210
- Infectious Diseases Institute, The Ohio State University, Columbus, OH43210
| | - Meera G. Nair
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA92521
| | - Juliet Morrison
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA92521
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Karamustafaoğlu YA, Yanık F, Yörük Y. Wedge resection and pleurodesis through single-incision videothoracoscopic transmediastinal approach for bilateral spontaneous pneumothorax. Turk Gogus Kalp Damar Cerrahisi Derg 2023; 31:295-299. [PMID: 37484633 PMCID: PMC10357863 DOI: 10.5606/tgkdc.dergisi.2023.20843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/17/2021] [Indexed: 07/25/2023]
Abstract
In general, in cases of bilateral primary pneumothorax, videoassisted thoracoscopic surgery procedures are performed sequentially on both sides. However, there are only a few reported cases of bullectomy through video-assisted thoracoscopic surgery using a transmediastinal approach for bilateral primary spontaneous pneumothorax. A 20-year-old male patient was admitted to our clinic with a right pneumothorax and developed a left pneumothorax four days later while he was under treatment. He underwent bilateral bullectomy and pleurodesis via a singleincision video-assisted thoracoscopic surgery in the supine position. The patient was discharged uneventfully within 72 h after the procedure. In conclusion, bilateral bullectomy and pleurodesis using single-incision transmediastinal access video-assisted thoracoscopic surgery may be good choices that are technically reliable and provide favorable surgical outcomes.
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Affiliation(s)
| | - Fazlı Yanık
- Department of Thoracic Surgery, Medicine Faculty of Trakya University, Edirne, Türkiye
| | - Yener Yörük
- Department of Thoracic Surgery, Medicine Faculty of Trakya University, Edirne, Türkiye
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3
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Hayashi S, Kim JH, Jin ZW, Murakami G, Rodríguez-Vázquez JF, Abe S. Cavitation processes in a space filled with loose mesenchymal tissues: a comparison between the retrosternal space and the middle ear tympanic cavity in human fetuses. Folia Morphol (Warsz) 2022. [PMID: 35285509 DOI: 10.5603/FM.a2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 11/25/2022]
Abstract
During the expansion of the pleural cavity in early fetuses, a thick sheet of loose mesenchymal tissue (SLMT) appears between the lung bud and body wall. Subsequently, the growing lung bud invades into the SLMT and the latter becomes fragmented to disappear. To compare this with the tympanic cavity filled with loose mesenchymal tissues, the present study aimed to demonstrate the development, establishment, and breaking of the SLMT in the retrosternal space. Although the retrosternal tissue was almost absent or very thin at 7 weeks, the SLMT appeared behind the manubrium sterni at 8 weeks. Accordingly, at 9-10 weeks, cavitation occurred in the SLMT to expand the pleural cavity. Therefore, the volume of SLMT was not determined by the adjacent structures such as the pericardium and sternum. Likewise, mesenchymal tissues filling the middle ear disappeared after 26 weeks. There were considerable individual variations in the timing of beginning and location of the tympanic cavitation. However, in contrast to the retrosternal SLMT, the volume of the future tympanic cavity is determined by the adjacent hard tissue and tympanic membrane much earlier than the cavitation. The mesenchymal tissue carried abundant vessels in the middle ear but none or few veins in the retrosternal SLMT. The concept that the lung bud invades into the splanchnic mesoderm to expand the pleural cavity seems oversimplified. Mechanical stresses from the pleural cavity might induce retrosternal cavitation, while a loss in blood supply might cause tympanic cavitation.
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4
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Solari E, Marcozzi C, Ottaviani C, Negrini D, Moriondo A. Draining the Pleural Space: Lymphatic Vessels Facing the Most Challenging Task. Biology (Basel) 2022; 11:biology11030419. [PMID: 35336793 PMCID: PMC8945018 DOI: 10.3390/biology11030419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/25/2022] [Accepted: 03/08/2022] [Indexed: 01/06/2023]
Abstract
Simple Summary Fluid drainage operated by lymphatic vessels is crucial for a proper volume homeostasis of body compartments. This role is particularly relevant for the pleural cavity, where the hydraulic pressure of the pleural liquid is very subatmospheric and fluid filtering from the blood capillaries into the pleural space must be continuously removed to keep the pleural space volume low and to prevent accumulation of liquid causing impairments of the respiratory mechanics. In order to accomplish this task, lymphatic vessels of the pleural side of the diaphragm and those lying on the pleural surface of the chest wall must possess a negative intraluminal pressure which has to vary during the respiratory cycle to follow the similar variations occurring to the pressure of pleural liquid. This review focuses on the in vivo pressure measurements performed in sedated animal models to understand how these lymphatic networks can accomplish this complex but pivotal role. Abstract Lymphatic vessels exploit the mechanical stresses of their surroundings together with intrinsic rhythmic contractions to drain lymph from interstitial spaces and serosal cavities to eventually empty into the blood venous stream. This task is more difficult when the liquid to be drained has a very subatmospheric pressure, as it occurs in the pleural cavity. This peculiar space must maintain a very low fluid volume at negative hydraulic pressure in order to guarantee a proper mechanical coupling between the chest wall and lungs. To better understand the potential for liquid drainage, the key parameter to be considered is the difference in hydraulic pressure between the pleural space and the lymphatic lumen. In this review we collected old and new findings from in vivo direct measurements of hydraulic pressures in anaesthetized animals with the aim to better frame the complex physiology of diaphragmatic and intercostal lymphatics which drain liquid from the pleural cavity.
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5
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Alotaibi AA, Albaqami FS, Almushayqih AK, Alotaibi GN, Aldakkan NF, Muammar JM, Alsulaimani AA, Alrowathi KI, Almansour AA, Alrushud SS, Aldeibani AA, Allohaibi AH, Aljohani BM, Aljohani A, Al-Hawaj F. Large Pleural Lipoma Manifesting With Chronic Shoulder Pain. Cureus 2022; 14:e21113. [PMID: 35165571 PMCID: PMC8830392 DOI: 10.7759/cureus.21113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/05/2022] Open
Abstract
Musculoskeletal symptoms related to orthopedic conditions are highly prevalent worldwide and are a leading cause of morbidity. However, non-orthopedic conditions may also present with musculoskeletal symptoms. For example, shoulder pain may be caused by gastrointestinal, hepatobiliary, cardiac, and neurological pathologies. We report the case of a 32-year-old man who presented to the orthopedic clinic with a complaint of left shoulder pain for the past three months. He described the pain as sharp in nature. The pain was constant and was not related to the shoulder movements. It was not associated with morning stiffness. He had no history of preceding trauma. On examination, both shoulders were symmetrical with no evidence of deformities. Palpation over the shoulder region did not elicit any tenderness. The range of motion in both the active and passive movements was intact. The Neer and Jobe tests were negative. Also, the sensory examination was intact, and laboratory findings were normal. The patient underwent a plain frontal radiograph of the chest, which revealed a large well-circumscribed lobulated mass lesion in the left hemithorax, arising from the pleural lining. A thoracic CT scan was then performed to provide further characterization of the mass lesion and it re-demonstrated the mass as having homogeneous fat-attenuation with thin septations, probably representing pleural lipoma. The tumor was successfully resected via open thoracotomy. The patient's symptoms resolved and he had no recurrence after one year of follow-up. Pleural lipoma is a very rare benign mesenchymal tumor. The case highlights the importance of considering non-orthopedic conditions in the differential diagnosis of shoulder pain in patients with normal physical examination findings. A CT scan is vital to make the diagnosis and can show the accurate anatomic relations with respect to the tumor for surgical planning.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Amal H Allohaibi
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Basmah M Aljohani
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Ahmed Aljohani
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Faisal Al-Hawaj
- Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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6
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Mousavi FR, Alavi E, Hirad NA. A Rare Diagnosis of Strongyloides stercoralis in the Pleural Cavity. HCA Healthc J Med 2021; 2:335-338. [PMID: 37425129 PMCID: PMC10324738 DOI: 10.36518/2689-0216.1199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Description Strongyloides stercoralis is a soil-transmitted helminth that causes strongyloidiasis, a chronic parasitic infection in humans. S. stercoralis is one of several worm species that cause soil-transmitted helminthiasis, a neglected tropical disease. Herein, we discuss a 78-year-old female residing in a nursing home presenting with abdominal pain and shortness of breath. During a thoracentesis, physicians found multiple rhabditoid larvae consistent with S. stercoralis. However, before the procedure, a serial assessment of stool sample was performed and failed to demonstrate a parasitic infestation. Many of those infected with S. stercoralis are asymptomatic. Lack of symptoms and low sensitivity in traditional parasitological testing hampers and delays the diagnosis of strongyloidiasis. This case serves as a reminder to consider helminthic disease in the differential diagnosis.
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Affiliation(s)
| | - Emon Alavi
- Philadelphia College of Osteopathic Medicine, Moultrie, GA
| | - Nick A. Hirad
- Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL
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7
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Boria F, Rodriguez-Perez M, Vázquez-Vicente D, Castellanos T, Chacon E, Chiva L. Thoracic anatomical landmarks and uniportal VATS cardiophrenic lymph node resection in advanced ovarian cancer. Int J Gynecol Cancer 2021; 31:793-794. [PMID: 33795423 DOI: 10.1136/ijgc-2021-002425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Felix Boria
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
| | | | | | - Teresa Castellanos
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
| | - Enrique Chacon
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
| | - Luis Chiva
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
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Stukan M, Bugalho A, Kumar A, Kowalewska J, Świetlik D, Buda N, Pietrzak-Stukan M, Dudziak M. Lung and Intercostal Upper Abdomen Ultrasonography for Staging Patients with Ovarian Cancer: A Method Description and Feasibility Study. Diagnostics (Basel) 2020; 10:E85. [PMID: 32033429 PMCID: PMC7167950 DOI: 10.3390/diagnostics10020085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 01/18/2023] Open
Abstract
A detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to computed tomography for assessing pelvic/abdominal tumor spread disease in women with epithelial ovarian cancer (EOC). This study aimed to describe and assess the feasibility of lung and intercostal upper abdomen ultrasonography as pretreatment imaging of EOC metastases of supradiaphragmatic and subdiaphragmatic areas. A preoperative ultrasound examination of consecutive patients suspected of having EOC was prospectively performed using transvaginal, transabdominal, and intercostal lung and upper abdomen ultrasonography. A surgical-pathological examination was the reference standard to ultrasonography. Among 77 patients with histologically proven EOC, supradiaphragmatic disease was detected in 13 cases: pleural effusions on the right (n = 12) and left (n = 8) sides, nodular lesions on diaphragmatic pleura (n = 9), focal lesion in lung parenchyma (n = 1), and enlarged cardiophrenic lymph nodes (n = 1). Performance (described with area under the curve) of combined transabdominal and intercostal upper abdomen ultrasonography for subdiaphragmatic areas (n = 77) included the right and left diaphragm peritoneum (0.754 and 0.575 respectively), spleen hilum (0.924), hepatic hilum (0.701), and liver and spleen parenchyma (0.993 and 1.0 respectively). It was not possible to evaluate the performance of lung ultrasonography for supradiaphragmatic disease because only some patients had this region surgically explored. Preoperative lung and intercostal upper abdomen ultrasonography performed in patients with EOC can add valuable information for supradiaphragmatic and subdiaphragmatic regions. A reliable reference standard to test method performance is an area of future research. A multidisciplinary approach to ovarian cancer utilizing lung ultrasonography may assist in clinical decision-making.
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Affiliation(s)
- Maciej Stukan
- Department of Gynecologic Oncology, Gdynia Oncology Center, Pomeranian Hospitals, 81-519 Gdynia, Poland
| | - Antonio Bugalho
- CUF Infante Santo Hospital, CUF Descobertas Hospital, NOVA Medical School, 1350-070 Lisbon, Portugal
| | - Amanika Kumar
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Julita Kowalewska
- Department of Radiology, Pomeranian Hospitals, 81-519 Gdynia, Poland
| | - Dariusz Świetlik
- Department of IT and Biostatistic, Gdańsk Medical University, 80-211 Gdańsk, Poland
| | - Natalia Buda
- Internal Medicine, Connective Tissue Diseases and Geriatrics Department, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | | | - Mirosław Dudziak
- Department of Gynecologic Oncology, Gdynia Oncology Center, Pomeranian Hospitals, 81-519 Gdynia, Poland
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9
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Larish A, Mert I, McGree M, Weaver A, Sheedy S, Cilby W. Recurrence patterns in patients with abnormal cardiophrenic lymph nodes at ovarian cancer diagnosis. Int J Gynecol Cancer 2020; 30:504-508. [PMID: 31953350 DOI: 10.1136/ijgc-2019-000981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/19/2019] [Accepted: 12/26/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Metastases in cardiophrenic lymph nodes noted at diagnosis of epithelial ovarian cancer confer a poor prognosis. It is unclear if cardiophrenic nodal metastases portend an atypical pattern of recurrence. We report on patients with radiographically involved cardiophrenic lymph nodes who underwent optimal primary debulking surgery to describe patterns of recurrence and response to chemotherapy. METHODS Patients undergoing primary debulking surgery for stage IIIC/IV epithelial ovarian carcinoma with residual disease ≤1.0 cm at our institution from 2003 to 2011 with a pre-operative computed tomography (CT) scan were identified. Scans were reviewed by blinded radiologists, who identified abnormal cardiophrenic lymph nodes via a qualitative assessment scale based on size, heterogeneity, and architecture. RESULTS Of the 250 patients identified, a recurrence site was documented in 22/27 (81.5%) with abnormal pre-operative cardiophrenic lymph nodes (defined by an elevated Qualitative Assessment Scale (QAS) score of ≥4), and in 128/223 (57.4%) without abnormal pre-operative cardiophrenic lymph nodes. Median short axis and long axis lymph node diameters for these patients was 9 (range 6-15) mm and 15 (range 11-22) mm, respectively. Cardiophrenic lymph nodes were resected in one patient. Patients with abnormal cardiophrenic nodes are more likely to have synchronous recurrence in thorax/pelvis and abdomen (50.0% (11/22) vs 25.0% (32/128), p=0.02) and less likely to have isolated recurrence in pelvis or abdomen (40.9% (9/22) vs 68.0% (87/128)). All patients who had a CT scan after six cycles of chemotherapy had improvement (defined as reduction of QAS score) in cardiophrenic lymphadenopathy. CONCLUSIONS Despite cardiophrenic adenopathy demonstrating a complete radiographic response to chemotherapy, their presence pre-operatively is associated with an increased risk of recurrence in the thorax. Knowledge of this propensity to recur in the thorax is important to ensure all extra-abdominal recurrence sites are diagnosed and managed appropriately.
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Affiliation(s)
- Alyssa Larish
- Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ismail Mert
- Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michaela McGree
- Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Amy Weaver
- Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Shannon Sheedy
- Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - William Cilby
- Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
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10
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Kelbich P, Malý V, Matuchová I, Čegan M, Staněk I, Král J, Karpjuk O, Moudrá-Wünschová I, Kubalík J, Hanuljaková E, Krejsek J. Cytological-energy analysis of pleural effusions. Ann Clin Biochem 2019; 56:630-637. [PMID: 31037951 DOI: 10.1177/0004563219845415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Simultaneous cytological and metabolic investigation of the pleural effusion provides clinically relevant information about the type and intensity of immune response in the pleural cavity. Methods We investigated 1329 pleural effusions from patients with different pathological changes in the pleural cavity. Evaluated parameters were differential cell count of neutrophils, eosinophils, lymphocytes and monocytes, and values of the coefficient of energy balance. Results We found the lowest numbers of cells and the highest coefficient of energy balance values in patients with heart failure and sepsis; relatively high frequency of eosinophils and slightly decreased coefficient of energy balance values in patients with pneumothorax and haemothorax; the predominance of lymphocytes and low coefficient of energy balance values in patients with tuberculous pleuritis; the predominance of neutrophils and variable coefficient of energy balance values in patients after chest surgery; the highest presence of neutrophils and very low coefficient of energy balance values in patients with chest empyema and the predominance of lymphocytes and normal to low coefficient of energy balance values in patients with pleural malignancy. Conclusions Our findings in patients with heart failure and sepsis suggest the absence of inflammation in the pleural cavity. We observed the manifestation of tissue repair in patients with pneumothorax and haemothorax. Patients with tuberculous pleuritis were predominantly characterized by T cell-driven immune response and oxidative burst of macrophages. We found different intensities of immune responses to the chest surgery. The typical finding in patients with empyema was oxidative burst of neutrophils. In patients with pleural malignancy, weak cytotoxic inflammation predominates together with the intensive inflammation characterized by oxidative burst of macrophages.
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Affiliation(s)
- Petr Kelbich
- Biomedical Centre, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic.,Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, Prague, Czech Republic.,Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
| | - Vilém Malý
- Department of Thoracic Surgery, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic
| | - Inka Matuchová
- Biomedical Centre, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic.,Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, Prague, Czech Republic.,Department of Clinical Immunology and Allergology, Faculty of Medicine and University Hospital in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic
| | - Martin Čegan
- Department of Pathology, Masaryk Hospital Ústí nad Labem, Ústí Labem nad, Czech Republic
| | - Ivan Staněk
- Department of Thoracic Surgery, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic
| | - Jiří Král
- Department of Thoracic Surgery, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic
| | - Ondřej Karpjuk
- Department of Thoracic Surgery, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic
| | - Irena Moudrá-Wünschová
- Department of Thoracic Surgery, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic
| | - Jan Kubalík
- Department of Thoracic Surgery, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic
| | - Eva Hanuljaková
- Biomedical Centre, Masaryk Hospital Ústí nad Labem, Ústí nad Labem, Czech Republic.,Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, Prague, Czech Republic
| | - Jan Krejsek
- Department of Clinical Immunology and Allergology, Faculty of Medicine and University Hospital in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic
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11
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Matsukuma S, Oshika Y, Utsumi Y, Obara K, Tanimoto T, Katsurada Y, Takeo H. Pleural dedifferentiated liposarcoma: A case report. Mol Clin Oncol 2019; 10:132-136. [PMID: 30655988 DOI: 10.3892/mco.2018.1757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/23/2018] [Indexed: 11/06/2022] Open
Abstract
The present case report describes a rare case of pleural liposarcoma. A 45-year-old Japanese man was hospitalized for increasing left chest pain. Imaging revealed a 10-cm pleural tumor and a 1.7-cm contralateral right pulmonary nodule. Biopsy specimens of the pleural tumor showed undifferentiated spindle-shaped and/or rounded sarcomatous features with myxoid stroma. The patient underwent embolization of the arteries feeding the left pleural tumor and palliative partial resection of the pleural tumor. The surgically removed specimens exhibited similar undifferentiated sarcomatous features. The left pleural tumor regrew aggressively, and the patient succumbed to mortality ~4.2 months following hospitalization. Autopsy demonstrated a 35-cm left pleural tumor, metastasizing to both adrenal glands and lumbar vertebral bones, and a 2.2-cm primary adenocarcinoma of the right lung. The majority of the left pleural tumor and its metastases consisted of undifferentiated sarcomatous elements, however, scattered or aggregated lipoblasts were identified in localized areas adjacent to the diaphragm. Immunohistochemically, these lipoblasts were diffusely positive for MDM2 and focally positive for S-100 protein. Undifferentiated sarcomatous tumor cells were focally positive for MDM2 but negative for S-100 protein. This case was diagnosed as pleural dedifferentiated liposarcoma. The local aggressiveness of the pleural liposarcoma directly contributed to the patient's mortality. A review of the literature indicated that the dedifferentiated subtype may serve as a factor that is indicative of a poor prognosis for pleural liposarcoma.
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Affiliation(s)
- Susumu Matsukuma
- Department of Pathology, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan.,Health Care Center, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan
| | - Yoshiro Oshika
- Division of Thoracic Surgery, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan
| | - Yoshitaka Utsumi
- Department of Pathology, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan
| | - Kiyohaya Obara
- Division of Thoracic Surgery, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan
| | - Takao Tanimoto
- Division of Respiratory Medicine, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan
| | - Yuka Katsurada
- Department of Pathology, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan
| | - Hiroaki Takeo
- Department of Pathology, Japan Self-Defense Forces Central Hospital, Tokyo 154-8532, Japan
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12
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Ding L, Hu Y, Zhao K, Wei G, Wu W, Wu Z, Xiao L, Huang H. Pleural cavity cytokine release syndrome in CD19-directed chimeric antigen receptor-modified T cell therapy: A case report. Medicine (Baltimore) 2018; 97:e9992. [PMID: 29443792 PMCID: PMC5839873 DOI: 10.1097/md.0000000000009992] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Cytokine release syndrome (CRS) is a common and potentially fatal complication of CAR-T cell therapy. However, compartment CRS is relatively rare in hematological malignancies, as well as in solid tumors. The pathogenesis and prognosis of compartment CRS are unclear and there is no standardized treatment yet. In this case report, we will introduce a patient developing pleural cavity CRS after CART19s infusion. PATIENT CONCERNS A 28-year-old woman was admitted for evaluation of mediastinal mass. Her relevant examinations were comoleted. DIAGNOSES She was diagnosed as diffuse large B cell lymphoma (DLBCL, non-GCB type). INTERVENTIONS She received chemotherapies including 1 cycle of R-DAEPORCH, 1 cycle of R-CHOPE, 2 cycles of R-CHOP, and 4 cycles of R-GDP during the disease course. OUTCOMES The cytokine levels of hydrothorax were considerably high when serum cytokines were within normal range, with IL-6 at 1212.45 versus 5.69 pg/mL. qPCR analysis for CAR constructs showed 1,119,696 copies/μg DNA in hydrothorax and 522,227 copies/μg DNA in blood. LESSONS The results indicated that CART19 cells trafficked to the pleural cavity and interacted with the CD19-positive lymphoma cells directly, causing cytokine release in situ.
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Affiliation(s)
| | | | - Kui Zhao
- PET/CT Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | | | | | - Zhao Wu
- Innovative Cellular Therapeutics Co., Ltd, Shanghai, China
| | - Lei Xiao
- Innovative Cellular Therapeutics Co., Ltd, Shanghai, China
| | - He Huang
- Bone Marrow Transplantation Center
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Lin F, Yang M, Pu Q, Ma L, Liu C, Mei J, Guo C, Liu L. Malignant glomus tumor in pleural cavity. J Thorac Dis 2015; 7:E126-30. [PMID: 26101658 DOI: 10.3978/j.issn.2072-1439.2015.04.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/10/2015] [Indexed: 02/05/2023]
Abstract
Glomus tumors, an uncommon hypervascular tumor, arise from modified smooth muscle cells of the glomus body that plays a significant role in the regulation of skin circulation. The tumors are usually located in the extremities, typically in the subungual region of the fingers. Primary glomus tumors of the chest are extremely rare, and to our knowledge, there are no cases have been described in thoracic cavity to date. We here report a case of intrathoracic glomus tumor in a 31-year-old man who presented with a persistent chest pain. Chest computed tomography scans demonstrated an irregularly shaped mass in the left thorax. Left thoracotomy was performed under the suspicious diagnosis of unexplained thorax tumor, and a tumor located in the left upper portion of thorax was founded. Complete resection of tumor along with the partial structure of chest wall was performed. Postoperative diagnosis was malignant glomus tumor.
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Affiliation(s)
- Feng Lin
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Mei Yang
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Qiang Pu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Lin Ma
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Chengwu Liu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Jiandong Mei
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Chenglin Guo
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Lunxu Liu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
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Misiak P, Wcislo S, Jabłoński S, Szwalbe K. Primary malignant peripheral nerve sheath tumor of the pleural cavity: rapid progression. Kardiochir Torakochirurgia Pol 2014; 11:213-5. [PMID: 26336424 DOI: 10.5114/kitp.2014.43854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 06/14/2013] [Accepted: 07/15/2013] [Indexed: 11/25/2022]
Abstract
Malignant peripheral nerve sheath tumor (MPNST) accounts for 5-10% of all malignant soft tissue tumors. It often affects the extremities and abdominal cavity and very rarely develops in the thoracic cavity. The incidence in the general population is 0.001%. In our paper we would like to present a case report of a 74-year-old female patient with primary MPNST of the pleural cavity which was previously misdiagnosed as a non-small cell lung cancer. Despite the combined treatment, after four months the patient developed a secondary tumor in the contralateral pleural cavity which was also treated operatively.
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Yi JH, Sim J, Park BB, Lee YY, Jung WS, Jang HJ, Ha TK, Paik SS. The primary extra-gastrointestinal stromal tumor of pleura: a case report and a literature review. Jpn J Clin Oncol 2013; 43:1269-72. [PMID: 24168806 DOI: 10.1093/jjco/hyt158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The gastrointestinal stromal tumor is the most common mesenchymal neoplasm of the gastrointestinal tract. The gastrointestinal stromal tumor universally expresses KIT and DOG-1 and frequently harbors oncogenic mutations in the KIT gene. While the gastrointestinal stromal tumor usually arises in the alimentary tract, it is rarely found in the extragastrointestinal area. When it is, it is called an extragastrointestinal stromal tumor. Although the pathogenesis, prognostic factors and outcomes of gastrointestinal stromal tumors are well known, those of extragastrointestinal stromal tumors have not been fully studied. We report, herein, a unique primary extragastrointestinal stromal tumor from the pleura in a 73-year-old woman who presented with pleural mass. The extragastrointestinal stromal tumor was surgically resected and confirmed by means of an immunohistochemical study and a molecular analysis.
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Affiliation(s)
- Jun Ho Yi
- *Department of Pathology, Hanyang University Seoul Hospital, Seoul, Korea; 222 Wangsimni 2-dong, Seongdong-gu, Seoul 133-792, Korea.
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Abstract
A 12 yr old girl with type 1 diabetes presented in ketoacidosis and consolidation of left lower lobe along with left pleural effusion. A diagnosis of mucormycosis was made on smear examination of an exudative pleural aspirate. Left lower lobe lobectomy was performed along with drainage of pleural collection with tube thoracostomy. Worsening respiratory distress postoperatively due to increase in empyema fluid necessitated a second surgery. Pleuropulmonary involvement as seen in this patient is an extremely rare occurrence possibly related to the propensity of mucor to invade blood vessels rather than extend outwardly into pleural cavity.
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Affiliation(s)
| | | | - Kim Vaiphei
- Advanced Pediatric Center & Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Kln Rao
- Department of Pediatric Surgery
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