Needle biopsy of pleura. An evaluation in patients with pleural efusion of neoplastic origin

Malignant disease of the pleura: a histopathological study with special emphasis on diagnostic criteria and differentiation from reactive mesothelium

“…In 33 of the 71 malignant cases the primary site of neoplasia was established, lung, pancreas and breast being the most common. A similar finding has been reported by several authors (Samuels et al 1958, Hanosib ef al. 1961, Scerbo et al 1971, Frist et al 1979.…”

“…Furthermore, among our cases with malignancies, we observed only one instance of muscle infiltration in a tumour that assumed a mainly solid pattern. Samuels et al (1958) stated that atypical dense fibrosis in a pleural biopsy should raise a high grade of suspicion of malignancy. In our study, there was no statistical difference in the frequency of dense fibrosis between malignant and control cases, Neoplasia may induce a desmoplastic reaction of the sub-pleural stroma, but many of our benign cases showed the same changes.…”

“…The histological examination of a pleural needle biopsy is one of the most difficult tasks of the surgical pathologist (Donohoe, Katz & Matthews 1958, Mestitz, Purves & Pollard 1958, Samuels, Old & Howe 1958, Leggat 1959, Hanosib & Jarkusg 1961, Sison & Weiss 1962, Scerbo, Keltz & Stone 1971, Salyer, Eggleston & Erozan 1975, Von Hoff & Livolsi 1975, Deluccia & Reyes 1977, Frist, Kahan & Koss 1979, Winkelmann & Pfitzer 1980. Bizarre atypical mesothelium, crush artifacts and minute tissue fragments lend themselves to erroneous interpretation.…”

“…Yet an accurate diagnosis is important because the invasion of the pleura by a malignant neoplasm heralds an extremely poor prognosis, with only a few months survival. Most authors state that the histopathological diagnosis of neoplastic involvement of the pleura should rely on finding histological features of malignancy such as abnormal mitoses, hyperchromatic and enlarged nuclei (Mestitz et al 1958, Scerbo et al 1971, or the identification of atypical cells between fibres, or on the presence of lamellar, dense sub-pleural fibrosis, so-called atypical dense fibrosis (Samuels et al 1958). There are no large studies of the histopathological criteria which can be helpful for the diagnosis of malignancy in pleural needle biopsy specimens.…”

Value of ultrasonically guided needle biopsy of pleural masses: An under-utilized technique

“…Accidentally and interestingly, all results of UGNB were positive, but the cytologic results of the pleural effusion evaluations were negative. [19][20][21] From these results, we suggest that US and UGNB can increase the diagnostic rates for pleural masses and shorten the time to pathological diagnosis as well as patients' admissions. Practically, we have recently performed UGNB to diagnose pleural masses first when the pleural masses were found by chest radiograph, CT, or US.…”