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The Pleura

The Pleura. The Pleura. A mesothelial surface lining the lungs and mediastinum Mesothelial cells designed for fluid absorption Hallmark of disease is the effusion. Transudate (low protein) cardiac failure hypoproteinaemia. Exudate (high protein) pneumonia TB connective tissue disease

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The Pleura

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  1. The Pleura

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

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

  4. Purulent Effusion Full of acute inflammatory cells • Empyema • Can become chronic

  5. Pneumothorax Air in pleural space • Trauma • Rupture of bulla

  6. Large bullae

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

  8. Mesothelioma

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

  10. Metastases in Pleura

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

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