Pleuroma--a cancer-mimicking atelectatic pseudotumor of the lung. 55 consecutive cases studied by high KV radiography, bronchography, selective pulmonary angiography and needle biopsy

Our plain-English summary of Pleuroma--a cancer-mimicking atelectatic pseudotumor of the lung. 55 consecutive cases studied by high KV radiography, bronchography, selective pulmonary angiography and needle biopsy, by W.N. Sinner (RöFo, 1980).

The study

• Author: W.N. Sinner
• Journal: RöFo
• Published: 1980;133(6):578-84
• Cited by: 20 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A form of cancer--mimicking atelectatic pseudotumor of the lung called "pleuroma" is described. Since 1961 55 cases were studied by needle aspiration biopsy. Due to the usual "negative" results ("no cancer cells") of the needle biopsy, a radiographic pattern was recognized, of the basis of which the benignity of the lesion was correctly diagnosed in most cases. The radiographic appearance of these lesions was not only established with PA, lateral and oblique high KV radiographs, fluoroscopy with overpenetrated spot films, but also by bronchography, and selective pulmonary angiography. Needle biopsy was helpful in conforming a diagnosis in typical cases. However it was of paramount importance in atypical cases to recognize the lesion.

In plain English

This article, by a radiologist at Karolinska Hospital in Stockholm, described 55 consecutive patients with a 'pleuroma'. This is a non-cancerous mass of collapsed lung tissue lying against the pleura that can look like lung cancer on X-ray. Of the 55 patients, 45 were men and 10 were women, aged 30 to 79. Most had no symptoms, and the masses were found by chance on chest X-rays. All patients had needle biopsy, ten had bronchography and one had pulmonary angiography. Needle biopsy found cancer cells in one case, which proved to be an oat-cell carcinoma. All other cases were negative for cancer cells. 'Asbestos bodies' were seen in several cases, but no count was given. On follow-up, several masses shrank and none grew, although the author reported one to two percent false negatives in the follow-up material. The author concluded that the X-ray pattern allowed the masses to be recognized as benign in most cases. Needle biopsy helped confirm typical cases and was of paramount importance in atypical ones.

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 (55 consecutive cases studied with X-ray imaging, bronchography, selective pulmonary angiography and needle biopsy)
• Who was studied: 55 patients with atelectatic pseudotumor ('pleuroma') seen at Karolinska Hospital, Stockholm, studied by needle biopsy since 1961; 45 male and 10 female, aged 30 to 79 (male to female 4.5 to 1); most had no symptoms
• Exposure: Not a study of an asbestos exposure; 'asbestos bodies' were found in needle biopsies from several cases (number not given), including a 61-year-old woman with bilateral lesions
• Main results:
  • Most patients had no symptoms; the lesions were found accidentally on chest X-rays
  • Needle biopsy found cancer cells in one of the 55 cases, which proved to be an oat-cell carcinoma; all other cases were negative for cancer cells
  • On follow-up, several pseudotumors decreased in size and none increased
  • One to two percent false negatives were found in the follow-up material
  • Of the ten patients who had bronchography, in seven the bronchi did not enter the pseudotumor; in three with cylindrical bronchiectasis the bronchi entered the lesion
  • Asbestos bodies were found in the needle biopsy of a 61-year-old woman whose pseudotumor was classed as having an atypical appearance
• The authors' conclusion: The author concluded that a recognizable radiographic pattern allowed the benign nature of the lesion to be diagnosed in most cases. Needle biopsy helped confirm typical cases and was of paramount importance for recognizing atypical ones. Growth of such a lesion suggests an underlying malignant process.
• Limitations the authors state:
  • Because of the fibrous tissue, needle aspiration alone sometimes obtained insufficient material, and a larger punch needle had to be used
  • It is sometimes difficult to fill the bronchial tree with contrast all the way out to a peripheral lesion during bronchography

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Needle Biopsy, Biopsy.

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