Diffuse malignant mesothelioma may be the most common range, accounting for 75% of principal tumors from the pleura, the prognosis is certainly ominous and it is associated with contact with asbestos, the U. He provides received several denominations: pleural fibroma, fibrous mesothelioma, pleural fibroma submesothelial, pleural fibrous tumor localized or solitary fibrous tumor of pleura.The first descriptions of primary pleural tumors are related to Lietaud (1767) and Wagner (1870). Could be associated with heart stroke pleural2, 53, calcification present tumoral3, 16, 21, 33 and become multiples2, 42, 71.70. Inflammatory adhesions peritumoral are normal and may include tumor microscopico2, 21, 33, 37. Klemperer and Rabin32 in 1931 for the very first time pleural tumors split into localized and diffuse. Gradual growth sometimes obtaining large to fill up a whole hemitorax15, 70, may compress mediastinal organs, center chambers and great vessels (correct atrium and poor vena cava). Are asymptomatic radiographic acquiring in 40% to 60% of situations and nonspecific upper body symptoms accompanied with the resto12, 33, 37, 42, 53. and various other industrialized countries. Sometimes the current presence of hypervascularity may histologic appearance hemangiopericitoma 21 like. Histologically are comprised of spindle cells within a arbitrarily distributed collagen matrix, with regions of hyper-and hypocellularity in the same tumor. Mesothelioma located much less frequent may be the staying 25% of pleural neoplasms, their scientific behavior histopatogenia and differs from diffuse range and should end up being analyzed individually. Localized fibrous tumor of PLEURA Medical clinic Solitary fibrous tumor of pleura located may appear in all age range, but frequently between your 6th and 7th 10 years of vida16 with femenino2 sex predominance, 42 and periodic familial incidence, research electronica43 immunohistochemical and recommend its origins in the tissues submesothelial connective.S. There pulmonar3 intraparenchymal development situations, 42. Can connected with paraneoplastic syndromes such as for example hypertrophic osteoarthropathy, digital16 clubbing, 37, hypoglycemia (Doeg-Potter symptoms) 13, 14, 15 and galactorrea43. Pathology Tumors are circumscribed, encapsulated, pedunculated or sessile, the bottom implementation is within the visceral pleura in 75 to 80% of situations.
England21 set up histological requirements of malignancy such as for example hypercellularity, nuclear crowding and overlapping, pleomorphism, hemorrhage, intratumoral necrosis and high mitotic activity. With regards to the histopathological features of the percentage of malignancy in the released series ranged between 36 and 40% 2, 21, 33, 37, Tumors using a diameter higher than 8 cm with isolated pleomorphism could be thought to be intermediate malignidad53 range. Studies also show by immunostaining for keratin and negativity positivity for vimentin, Compact disc34 antibody, hormone receptor and progesterone aspect prooncogenico antiapoptotic bcl-2. The definitive medical diagnosis and differentiation from various other tumores16 can only just completed after an intensive histopathological study of the tumor specimen entirely, which can be necessary to determine the malignancy or kindness, specifically in large tumors, provided the heterogeneous character of the neoplasms, their unstable biological behavior, not necessarily related histologicos21 his heroes. Led percutaneous puncture CT is definitely diagnostic in 55% of instances, although Weynard in 53 individuals received a analysis of 100% positivity by using needle Trucut. Positron emission tomography (18 FG-PET Check out) showed improved uptake just in malignant tumors, however the few individuals in the released series limit their validity and rol33.Diagnostic Strategies The chest radiograph allows a short orientation and character are described peduncular shape and position adjustments with the various tumor decubitos43. Computed tomography (CT) does not have diagnostic specificity and differentiation with tumors from the upper body wall structure, mediastinal or lung is normally to Occasionally difici12, 37. Nuclear magnetic resonance (NMR) just shows the type fibrous lesion. Cytogenetic research showed which the mutation in the gene proapoptotic p53, Ki67 positivity and Compact disc31 antigens and lack of Compact disc34 antigen appearance have been connected with an intense and badly neoplasia16 forecast. The last mentioned allows the medical diagnosis hemangiopericytoma differential, which may be positive for Compact disc34 but detrimental the antiapoptotic bcl-2.