Localized fibrous tumors (LFTs) of the pleura: clinical data, asbestos burden, and syntactic structure analysis applied to newly defined angiogenic/growth-regulatory effectors

Our plain-English summary of Localized fibrous tumors (LFTs) of the pleura: clinical data, asbestos burden, and syntactic structure analysis applied to newly defined angiogenic/growth-regulatory effectors, by K. Kayser, J. Trott, G. Böhm, et al (Pathology, Research and Practice, 2005).

The study

• Authors: K. Kayser, J. Trott, G. Böhm, M. Huber, H. Kaltner, S. André, H.J. Gabius
• Journal: Pathology, Research and Practice
• Published: 2005;201(12):791-801
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This study was performed to add clinical data, to introduce new markers, and to perform syntactic structural analysis on localized fibrous tumors (LFTs) of the pleura. The material comprised clinical data and processed sections obtained from 36 patients. The results achieved from quantitative imaging techniques and syntactic structure analysis were correlated with clinical data, including patients' habits (smoking), asbestos exposure, survival, and tumor recurrence. The disease caused increasing chest pain and dyspnea in 47% of patients. Exposure to asbestos was noted in 13 out of 36 patients, whereas smoking posed no major risk factor. Two patients developed a recurrent tumor after 8 and 42 months, respectively; none of the other patients died of this tumor disease within the follow-up period of maximal 212 months. The cases were clearly discriminated from mesotheliomas by the marker profile. Frequent expression of accessible ligands for endogenous lectins galectins-1 and -3, the expression of the angiogenic macrophage migration inhibitory factor (MIF), and the dense vascularization intimate a functional relationship. The proliferation index (Nv) was computed to be 1.6% in line with the balance of galectin expression. Abnormal p53 was expressed in only 19.4% of the cases. The diagnosis of LFT can be aided by quantitative assessment of vimentin, CD34, MIF, vascularization, and proliferation. Considering the galectin network, differential expression was noted with preference to effectors limiting growth and aggressiveness.

In plain English

This study examined localized fibrous tumors (LFTs) of the pleura, which the authors classify as separate from mesothelioma. It covered 36 patients whose tumors were surgically removed, 21 from Vienna and 15 from Heidelberg, with follow-up of up to 212 months. The authors stained tumor tissue with a panel of markers, measured tissue patterns by image analysis, and counted fibers in lung tissue under a light microscope. They did not name fiber types. Asbestos exposure was confirmed in 13 of 36 patients and excluded in 17. Mean fiber concentration was 50 (plus or minus 15) fibers per gram of wet tissue in all patients and 62 (plus or minus 27) in those with known exposure. The authors gave the normal value as below 15 fibers per gram of wet tissue. Six patients died during follow-up, one of asbestos-associated mesothelioma, and two had recurrent tumors. Women and unexposed patients tended to survive longer, but not at a statistically significant level. The authors concluded that LFTs are benign and that asbestos exposure, with low to moderately raised lung fiber levels, was found in a high percentage of these patients.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series of surgically removed tumors (pathology study), with clinical follow-up, tissue staining, semi-automated image analysis and lung fiber counting
• Who was studied: 36 patients with LFTs of the pleura (16 men, 20 women): 21 cases from the Institute of Pathology, Klinikum Baumgartner Höhe, Vienna, and 15 from the Thoraxklinik, Heidelberg. All had surgical excision. The authors state a minimum follow-up of 24 months and a maximum of 212 months, but their Table 2 lists deaths at 8 and 12 months. The study years are not stated.
• Exposure: Asbestos exposure taken from clinical records, and asbestos burden (ferruginous bodies) counted by light microscopy after wet digestion of lung tissue. No fiber types, products or jobs are given. Smoking was also recorded.
• Main results:
  • Pain and other symptoms such as pleural effusions occurred in 17 of 36 patients.
  • Asbestos exposure was confirmed in 13 of 36 patients and excluded in 17 of 36.
  • Mean lung fiber concentration was 50 plus or minus 15 fibers/g wet tissue in all patients, and 62 plus or minus 27 fibers/g wet tissue in those with known asbestos exposure.
  • The authors gave the normal lung value as below 15 fibers/g wet tissue.
  • 6 of 36 patients (3 men, 3 women) died during follow-up. According to Table 2, two died after relapse, one (a 33-year-old woman) of asbestos-associated mesothelioma at 12 months, one of lymphoid granulomatosis, and two of multiple chronic diseases.
  • Recurrent tumors occurred in 2 of 36 patients.
  • Women (103 months) and patients without asbestos exposure (84 months) tended toward longer survival, but the difference was not statistically significant. The median survival for all patients was 67.5 months.
  • Smoking had no influence on survival length.
  • Smooth muscle actin and calretinin were not detected in the tumors. Vimentin was present in 34 of 36 cases, and Table 3 lists CD34 in 35 (97.2%) and MIF in 33 (91.7%).
  • The proliferation index was 1.6%, and abnormal p53 was found in 19.4% of cases. The authors interpreted this as indicating a benign lesion.
• The authors' conclusion: The authors concluded that LFTs of the pleura are benign lesions with properties of a true neoplasm. They also concluded that asbestos exposure, with low to moderately raised lung fiber concentrations, was found in a high percentage of these patients, and that markers including CD34, vimentin, MIF and vascular features can aid diagnosis.

Topics

Medical terms in this study, explained in our Lexicon: Solitary Fibrous Tumor, Pleura, Habit, Asbestos Exposure, Dyspnea, Mesothelioma, Macrophage, CD34.

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