Calcifying fibrous tumour of the pleura without gross calcification

Our plain-English summary of Calcifying fibrous tumour of the pleura without gross calcification, by H.J. Lee, J.S. Jeong, Y.C. Lee (Respirology Case Reports, 2024).

The study

• Authors: H.J. Lee, J.S. Jeong, Y.C. Lee
• Journal: Respirology Case Reports
• Published: 2024;12(5):e01365
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Calcifying fibrous tumours of the pleura (CFTP) typically appear as calcified, non-enhancing lesions on chest CT scans. However, enhancing pleural lesions can mimic malignancy like mesothelioma. We report a rare case that enhancing pleural thickening, confirmed as CFTP through pathological examination, despite the absence of visible calcification on radiological imaging.

© 2024 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.

In plain English

This is a short case report (a 'clinical image') from Jeonbuk National University in the Republic of Korea. It describes one patient. A 19-year-old man was referred after a chest x-ray at his Army enlistment examination happened to show thickening of the pleura (the lining around the lung) on the right side. He had no symptoms and no exposure to asbestos, and had smoked 1–2 cigarettes a day for 1 year. A chest CT without contrast showed no signs of calcification. A contrast CT showed diffuse thickening of the right pleura and diaphragm with uneven enhancement. The authors note that enhancing lesions like this can mimic malignancy such as mesothelioma. Video-assisted thoracoscopic surgery found multiple soft, irregular masses, and the removed specimen measured 12.5 by 9.6 by 3.7 cm. Under the microscope it showed calcification, and stain results were consistent with calcifying fibrous tumour of the pleura. A CT 7 months later showed no local recurrence. The authors said the 3 mm CT slice thickness should be considered. They concluded that physicians need to suspect this tumour in pleural thickening with features of malignancy, whether or not calcification is visible on x-ray or CT.

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 report (clinical image) of a single patient
• Who was studied: one 19-year-old male referred to a pulmonology clinic in Jeonju, Republic of Korea, after an incidental finding on an Army enlistment chest x-ray; dates of care not stated
• Exposure: no asbestos exposure; the patient had smoked 1–2 cigarettes per day for 1 year
• Main results:
  • Non-enhanced chest CT showed no signs of calcification in the right pleural thickening
  • Contrast-enhanced chest CT showed diffuse thickening of the right pleural space involving the visceral pleura and right diaphragm, with heterogeneous enhancement
  • The authors stated that enhancing pleural lesions can mimic malignancy such as mesothelioma
  • Video-assisted thoracoscopic surgery found multiple soft mass lesions with irregular shapes throughout the right pleural space
  • The resected specimen measured 12.5 by 9.6 by 3.7 cm, with pleura about 1.4 cm thick
  • Haematoxylin and eosin staining showed calcification, described by the authors as psamommatous
  • Immunohistochemical staining was positive only for vimentin and negative for S-100 and CD-34, findings the authors described as comparable with calcifying fibrous tumour
  • A follow-up chest CT 7 months later showed no local recurrence, which the authors took to suggest complete surgical resection
• The authors' conclusion: The authors concluded that physicians need to suspect calcifying fibrous tumour of the pleura in cases of pleural thickening with features of malignancy, whether or not gross calcification is seen on chest x-ray or CT
• Limitations the authors state:
  • The authors noted that the chest CT slice thickness (3 mm in this case) should be considered when interpreting the CT results

Topics

Medical terms in this study, explained in our Lexicon: Pleura, CT Scan, Mesothelioma, Pleural Thickening.

Related studies

• Calcifying fibrous pseudotumor of mediastinum--a case report — H.S. Jeong, G.K. Lee, et al. (1997)
• Localized fibrous tumours of the pleura: 15 new cases and review of the literature — M. Suter, S. Gebhard, et al. (1998)
• Patterns of chromosomal imbalances in benign solitary fibrous tumours of the pleura — M. Krismann, H. Adams, et al. (2000)
• Solitary fibrous tumour of the pleura: an ultrastructural and immunohistochemical study — S. Keating, G.T. Simon, et al. (1987)
• Solitary fibrous tumour of the pleura: A case report — G. Rakovich, M. Laflamme, et al. (2010)
• Localized fibrous tumour of the pleura: two case reviews — F. Pond, A. Wilson, et al. (1997)

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