Tumours of the Pleura

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The most common tumour of the pleura is metastatic carcinoma.
Metastatic tumours are the most common cause of neoplasm in the pleura.
The most frequent primary sites are lung and breast, causing pleural effusion.

Metastasis to the pleura is usually associated with a high-protein exudate. Diagnosis can be made by cytology of aspirated fluid or by needle biopsy of the pleura.

Primary neoplasms of the pleura are rare except after exposure to asbestos, when tumours termed 'malignant mesotheliomas' develop. After exposure, there may be a latent period of up to 50 years before development of the tumour.
Patients have chest pain and breathlessness, and there is commonly a pleural effusion. Diagnosis is made on pleural biopsy.
Histologically, mesotheliomas have spindle cells and glandular patterns.
These are highly malignant tumours that spread around the pleural cavity and pericardium, encasing the lung and mediastinal structures. Death is usual within ten months of diagnosis, and metastasis is rare.
Exposure to asbestos also causes development of benign collagenous thickenings of the pleura, termed pleural plaques.
Mesothelioma is seen as a thick sheet of white tumour, which encases the whole of the lung.
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