| The Fake Fat Phenomenon in Organizing Pleuritis: A Source of Confusion With Desmoplastic Malignant Mesotheliomas. | |
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MedLine Citation:
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PMID: 21959310 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We report 9 patients with pleural biopsies referred because of concern about infiltration of what appeared to be chest wall fat by pan-keratin-positive spindled cells, a finding that led to a consideration of desmoplastic mesothelioma. All patients showed pleural effusions/pleural thickening on computed tomographic scan. Pleural biopsy showed a greatly thickened and fibrotic paucicellular pleura with circular fat-like spaces and, sometimes, adjacent oblate spaces mostly deep in the fibrotic area. Indistinct, keratin-positive, spindle cells arranged parallel to the pleural surface coursed between these fat-like spaces. S-100 stains were negative around the fat-like spaces. Vimentin stains showed that the spaces did not have a cellular lining of any kind. Sometimes the spaces contained faintly hematoxyphilic material that was Alcian blue positive, and similar material was seen in the fibrotic stroma. Follow-up with periods ranging from 6 to 30 months revealed that 8 cases had stable disease on chest imaging or by clinical findings. One case had slowly progressive pleural thickening. These observations suggest that spaces resembling fat may be encountered in fibrotic pleurae and that horizontally oriented keratin-positive spindled cells between the fat-like spaces deep in the fibrotic portion of a thickened pleura represent a benign finding seen in some cases of organizing pleuritis/fibrothorax. The spaces themselves are probably artifacts derived from the biopsy procedure and/or cutting artifacts. In contrast, in true desmoplastic mesotheliomas there is downward, rather than horizontal, growth of keratin-positive spindled cells running between clearly definable fat cells. |
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Authors:
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Andrew Churg; Philip Cagle; Thomas V Colby; Joseph M Corson; Allen R Gibbs; Samuel Hammar; Nelson Ordonez; Victor L Roggli; Henry D Tazelaar; William D Travis; Mark Wick; |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-28 |
Journal Detail:
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Title: The American journal of surgical pathology Volume: - ISSN: 1532-0979 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7707904 Medline TA: Am J Surg Pathol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Department of Pathology, University of British Columbia, Vancouver, BC, Canada †Department of Pathology, The Methodist Hospital, Houston, Texas and Weill Medical College of Cornell University ††Department of Pathology, Memorial-Sloan Kettering Cancer Center, NY ‡Mayo Clinic in Arizona, Scottsdale, AZ §Department of Pathology, Harvard Medical School, Boston, MA ∥Department of Histopathology, University Hospital Llandough, Penarth, UK ¶Diagnostic Specialties Laboratory, Bremerton, WA #Department of Pathology, MD Anderson Cancer Center, Houston, TX **Department of Pathology, Duke University Medical Center, Durham, NC ‡‡Department of Pathology, University of Virginia Health System, Charlottesville, VA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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