The Pleura in Health and Disease

ABSTRACT

A wide variety of local, regional, and systemic diseases may have pleural manifestations. The scope of this pathology encompasses a wide spectrum ranging from minimal inflammatory changes to highly malignant neoplasms. An overview of the normal structure of the pleura is provided, along with the diseases that may be encountered. Pleural specimens from patients with pneumothorax are rarely encountered by pathologists. In contrast, pathologists frequently receive pleural specimens showing evidence of inflammation, repair, or neoplasm. In these circumstances, an awareness of less common (and often clinically highly important) conditions such as epithelioid hemangioendothelioma and primary pleural malignant mesothelioma is essential. Knowledge of the clinical setting (e.g., disease tempo) and radiological picture (e.g., laterality) is often of great value to the pathologist in arriving at a correct diagnosis. Similarly, knowledge of the normal anatomical considerations and familiarity with the expected pleural histopathology for the most clinically relevant pleural diseases are critical assets for pulmonary physicians in providing optimal care for their patients.

KEYWORDS

Pleura - pathology - disease - infection - neoplasms - mesothelioma

REFERENCES

• 1 Davies J. Development of the respiratory system. In: Davies J, ed. Human Developmental Anatomy. New York: Ronald Press; 1963: 135-143
• 2 Wang N S. Anatomy of the pleura.  Clin Chest Med. 1998;  19 229-240
• 3 Sahn S A. State of the art: the pleura.  Am Rev Respir Dis. 1988;  138 184-234
• 4 Wang N S. The preformed stomas connecting the pleural cavity and the lymphatics in the parietal pleura.  Am Rev Respir Dis. 1975;  111 12-20
• 5 Ahmad Z, Krishnadas R, Froeschle P. Pleural effusion: diagnosis and management.  J Perioper Pract. 2009;  19 242-247
• 6 Jantz M A, Antony V B. Pathophysiology of the pleura.  Respiration. 2008;  75 121-133
• 7 Rahman N M, Chapman S J, Davies R J. The approach to the patient with a parapneumonic effusion.  Clin Chest Med. 2006;  27 253-266
• 8 Sahn S A. Pleural effusions of extravascular origin.  Clin Chest Med. 2006;  27 285-308
• 9 Gaudio E, Rendina E A, Pannarale L, Ricci C, Marinozzi G. Surface morphology of the human pleura. A scanning electron microscopic study.  Chest. 1988;  93 149-153
• 10 Tarn A C, Lapworth R. Biochemical analysis of pleural fluid: what should we measure?.  Ann Clin Biochem. 2001;  38(Pt 4) 311-322
• 11 Light R W, Macgregor M I, Luchsinger P C, Ball Jr W C. Pleural effusions: the diagnostic separation of transudates and exudates.  Ann Intern Med. 1972;  77 507-513
• 12 Pereira T C, Saad R S, Liu Y, Silverman J F. The diagnosis of malignancy in effusion cytology: a pattern recognition approach.  Adv Anat Pathol. 2006;  13 174-184
• 13 Bedrossian C W. Diagnostic problems in serous effusions.  Diagn Cytopathol. 1998;  19 131-137
• 14 Fetsch P A, Abati A. Immunocytochemistry in effusion cytology: a contemporary review.  Cancer. 2001;  93 293-308
• 15 Das D K. Serous effusions in malignant lymphomas: a review.  Diagn Cytopathol. 2006;  34 335-347
• 16 Reis-Filho J S, de Landér Schmitt F C. Fluorescence in situ hybridization, comparative genomic hybridization, and other molecular biology techniques in the analysis of effusions.  Diagn Cytopathol. 2005;  33 294-299
• 17 Roggli V L. Role of closed-needle biopsy in the diagnosis of malignant mesothelioma of the pleura.  Chest. 1994;  105 321-322
• 18 Boutin C, Rey F. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients, I: Diagnosis.  Cancer. 1993;  72 389-393
• 19 Srinivas S, Varadhachary G. Spontaneous pneumothorax in malignancy: a case report and review of the literature.  Ann Oncol. 2000;  11 887-889
• 20 Kelly A M. Treatment of primary spontaneous pneumothorax.  Curr Opin Pulm Med. 2009;  15 376-379
• 21 Kurihara M, Kataoka H, Ishikawa A, Endo R. Latest treatments for spontaneous pneumothorax.  Gen Thorac Cardiovasc Surg. 2010;  58 113-119
• 22 Noppen M, De Keukeleire T. Pneumothorax.  Respiration. 2008;  76 121-127
• 23 Melton III L J, Hepper N G, Offord K P. Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974.  Am Rev Respir Dis. 1979;  120 1379-1382
• 24 Bense L, Wiman L G, Hedenstierna G. Onset of symptoms in spontaneous pneumothorax: correlations to physical activity.  Eur J Respir Dis. 1987;  71 181-186
• 25 Jordan K G, Kwong J S, Flint J, Müller N L. Surgically treated pneumothorax. Radiologic and pathologic findings.  Chest. 1997;  111 280-285
• 26 Bense L, Eklund G, Wiman L G. Smoking and the increased risk of contracting spontaneous pneumothorax.  Chest. 1987;  92 1009-1012
• 27 Bense L. Spontaneous pneumothorax.  Chest. 1992;  101 891-892
• 28 Askin F B, McCann B G, Kuhn C. Reactive eosinophilic pleuritis: a lesion to be distinguished from pulmonary eosinophilic granuloma.  Arch Pathol Lab Med. 1977;  101 187-191
• 29 Shilo K, Colby T V, Travis W D, Franks T J. Exuberant type 2 pneumocyte hyperplasia associated with spontaneous pneumothorax: secondary reactive change mimicking adenocarcinoma.  Mod Pathol. 2007;  20 352-356
• 30 Shields T W, Oilschlager G A. Spontaneous pneumothorax in patients 40 years of age and older.  Ann Thorac Surg. 1966;  2 377-383
• 31 Dines D E, Clagett O T, Payne W S. Spontaneous pneumothorax in emphysema.  Mayo Clin Proc. 1970;  45 481-487
• 32 George R B, Herbert S J, Shames J M, Ellithorpe D B, Weill H, Ziskind M M. Pneumothorax complicating pulmonary emphysema.  JAMA. 1975;  234 389-393
• 33 Newsome G S, Ward D J, Pierce P F. Spontaneous pneumothorax in patients with acquired immunodeficiency syndrome treated with prophylactic aerosolized pentamidine.  Arch Intern Med. 1990;  150 2167-2168
• 34 Gerein A N, Brumwell M L, Lawson L M, Chan N H, Montaner J S. Surgical management of pneumothorax in patients with acquired immunodeficiency syndrome.  Arch Surg. 1991;  126 1272-1276, discussion 1276–1277
• 35 Wilder R J, Beacham E G, Ravitch M M. Spontaneous pneumothorax complicating cavitary tuberculosis.  J Thorac Cardiovasc Surg. 1962;  43 561-573
• 36 Korom S, Canyurt H, Missbach A et al.. Catamenial pneumothorax revisited: clinical approach and systematic review of the literature.  J Thorac Cardiovasc Surg. 2004;  128 502-508
• 37 Marshall M B, Ahmed Z, Kucharczuk J C, Kaiser L R, Shrager J B. Catamenial pneumothorax: optimal hormonal and surgical management.  Eur J Cardiothorac Surg. 2005;  27 662-666
• 38 Peikert T, Gillespie D J, Cassivi S D. Catamenial pneumothorax.  Mayo Clin Proc. 2005;  80 677-680
• 39 Velasco Osés A, Hilario Rodriguez E, Santamaría García J L, Aramendi Sanchez T, Coma Corral M J, Pérez Serrano L. Catamenial pneumothorax with pleural endometriosis and hemoptysis.  Diagn Gynecol Obstet. 1982;  4 295-299
• 40 Kradin R L, Mark E J. Distinguishing benign mesothelial hyperplasia from neoplasia: a practical approach.  Semin Diagn Pathol. 2006;  23 4-14
• 41 Cagle P T, Churg A. Differential diagnosis of benign and malignant mesothelial proliferations on pleural biopsies.  Arch Pathol Lab Med. 2005;  129 1421-1427
• 42 Lee S F, Lawrence D, Booth H, Morris-Jones S, Macrae B, Zumla A. Thoracic empyema: current opinions in medical and surgical management.  Curr Opin Pulm Med. 2010;  16 194-200
• 43 Harley R A. Pathology of pleural infections.  Semin Respir Infect. 1988;  3 291-297
• 44 Hughes C E, Van Scoy R E. Antibiotic therapy of pleural empyema.  Semin Respir Infect. 1991;  6 94-102
• 45 Magovern C J, Rusch V W. Parapneumonic and post-traumatic pleural space infections.  Chest Surg Clin N Am. 1994;  4 561-582
• 46 Bender J M, Ampofo K, Sheng X, Pavia A T, Cannon-Albright L, Byington C L. Parapneumonic empyema deaths during past century, Utah.  Emerg Infect Dis. 2009;  15 44-48
• 47 Chalmers J D, Singanayagam A, Murray M P, Scally C, Fawzi A, Hill A T. Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia.  Thorax. 2009;  64 592-597
• 48 Krasnik M, Storm H K, Frimodt-Møller N. Pleural empyema.  [in Danish] Ugeskr Laeger. 1996;  158(15) 2109-2112
• 49 Antony V B, Mohammed K A. Pathophysiology of pleural space infections.  Semin Respir Infect. 1999;  14 9-17
• 50 Strange C, Sahn S A. Management of parapneumonic pleural effusions and empyema.  Infect Dis Clin North Am. 1991;  5 539-559
• 51 Bartlett J G. Bacterial infections of the pleural space.  Semin Respir Infect. 1988;  3 308-321
• 52 Everts R J, Reller L B. Pleural space infections: microbiology and antimicrobial therapy.  Semin Respir Infect. 1999;  14 18-30
• 53 Bartlett J G. Anaerobic bacterial infections of the lung and pleural space.  Clin Infect Dis. 1993;  16(Suppl 4) S248-S255
• 54 Abrams W B, Small M J. Current concepts of tuberculous pleurisy with effusion as derived from pleural biopsy studies.  Dis Chest. 1960;  38 60-65
• 55 Ibrahim W H, Ghadban W, Khinji A et al.. Does pleural tuberculosis disease pattern differ among developed and developing countries.  Respir Med. 2005;  99 1038-1045
• 56 Kim H J, Lee H J, Kwon S Y et al.. The prevalence of pulmonary parenchymal tuberculosis in patients with tuberculous pleuritis.  Chest. 2006;  129 1253-1258
• 57 George R B, Penn R L, Kinasewitz G T. Mycobacterial, fungal, actinomycotic, and nocardial infections of the pleura.  Clin Chest Med. 1985;  6 63-75
• 58 Lambert R S, George R B. Fungal diseases of the pleura: clinical manifestations, diagnosis, and treatment.  Semin Respir Infect. 1988;  3 343-351
• 59 Yazaki H, Goto N, Uchida K, Kobayashi T, Gatanaga H, Oka S. Outbreak of Pneumocystis jiroveci pneumonia in renal transplant recipients: P. jiroveci is contagious to the susceptible host.  Transplantation. 2009;  88 380-385
• 60 Kolditz M, Halank M, Bandt D, Spornraft-Ragaller P, Höffken G. Early recurrence of Pneumocystis jiroveci pneumonia in two HIV-infected patients: linking infection relapse and immune reconstitution syndrome.  Respirology. 2009;  14 910-912
• 61 Catanzaro A. Coccidioidomycosis.  Semin Respir Crit Care Med. 2004;  25 123-128
• 62 Cano M V, Hajjeh R A. The epidemiology of histoplasmosis: a review.  Semin Respir Infect. 2001;  16 109-118
• 63 Retallack D M, Woods J P. Molecular epidemiology, pathogenesis, and genetics of the dimorphic fungus Histoplasma capsulatum .  Microbes Infect. 1999;  1 817-825
• 64 Loulergue P, Mir O. Pleural empyema secondary to amebic liver abscess.  Int J Infect Dis. 2009;  13 e135-e136
• 65 Mayo F, Baier H. Cysticercotic cyst involving the pleura: an unusual case of an abnormal chest roentgenogram.  Arch Intern Med. 1979;  139 115-116
• 66 Im J G, Whang H Y, Kim W S, Han M C, Shim Y S, Cho S Y. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients.  AJR Am J Roentgenol. 1992;  159 39-43
• 67 Roberts P P. Parasitic infections of the pleural space.  Semin Respir Infect. 1988;  3 362-382
• 68 Williams T, Gostelow B, Woods D, Spyt T. Apical pleural mass developing following talc pleurodesis.  Respir Med. 1998;  92 358-359
• 69 Soskel N T, Sharma O P. Pleural involvement in sarcoidosis.  Curr Opin Pulm Med. 2000;  6 455-468
• 70 McDonnell T J, Crouch E C, Gonzalez J G. Reactive eosinophilic pleuritis: a sequela of pneumothorax in pulmonary eosinophilic granuloma.  Am J Clin Pathol. 1989;  91 107-111
• 71 Leslie K O, Trahan S, Gruden J. Pulmonary pathology of the rheumatic diseases.  Semin Respir Crit Care Med. 2007;  28 369-378
• 72 van Laar J M, Stolk J, Tyndall A. Scleroderma lung: pathogenesis, evaluation and current therapy.  Drugs. 2007;  67 985-996
• 73 Sahn S A. Immunologic diseases of the pleura.  Clin Chest Med. 1985;  6 83-102
• 74 Antony V B. Drug-induced pleural disease.  Clin Chest Med. 1998;  19 331-340
• 75 Huggins J T, Sahn S A. Drug-induced pleural disease.  Clin Chest Med. 2004;  25 141-153
• 76 Morelock S Y, Sahn S A. Drugs and the pleura.  Chest. 1999;  116 212-221
• 77 Huggins J T, Sahn S A. Causes and management of pleural fibrosis.  Respirology. 2004;  9 441-447
• 78 Mutsaers S E, Prele C M, Brody A R, Idell S. Pathogenesis of pleural fibrosis.  Respirology. 2004;  9 428-440
• 79 Mutsaers S E, Kalomenidis I, Wilson N A, Lee Y C. Growth factors in pleural fibrosis.  Curr Opin Pulm Med. 2006;  12 251-258
• 80 Jantz M A, Antony V B. Pleural fibrosis.  Clin Chest Med. 2006;  27 181-191
• 81 Miles S E, Sandrini A, Johnson A R, Yates D H. Clinical consequences of asbestos-related diffuse pleural thickening: a review.  J Occup Med Toxicol. 2008;  3 20
• 82 Clarke C C, Mowat F S, Kelsh M A, Roberts M A. Pleural plaques: a review of diagnostic issues and possible nonasbestos factors.  Arch Environ Occup Health. 2006;  61 183-192
• 83 Wain S L, Roggli V L, Foster Jr W L. Parietal pleural plaques, asbestos bodies, and neoplasia: a clinical, pathologic, and roentgenographic correlation of 25 consecutive cases.  Chest. 1984;  86 707-713
• 84 Donath J, Miller A. Restrictive chest wall disorders.  Semin Respir Crit Care Med. 2009;  30 275-292
• 85 Hillerdal G. Non-malignant asbestos pleural disease.  Thorax. 1981;  36 669-675
• 86 Stephens M, Gibbs A R, Pooley F D, Wagner J C. Asbestos induced diffuse pleural fibrosis: pathology and mineralogy.  Thorax. 1987;  42 583-588
• 87 Mintzer R A, Cugell D W. The association of asbestos-induced pleural disease and rounded atelectasis.  Chest. 1982;  81 457-460
• 88 Cugell D W, Kamp D W. Asbestos and the pleura: a review.  Chest. 2004;  125 1103-1117
• 89 Remy-Jardin M, Sobaszek A, Duhamel A, Mastora I, Zanetti C, Remy J. Asbestos-related pleuropulmonary diseases: evaluation with low-dose four-detector row spiral CT.  Radiology. 2004;  233 182-190
• 90 Arakawa H, Honma K, Saito Y et al.. Pleural disease in silicosis: pleural thickening, effusion, and invagination.  Radiology. 2005;  236 685-693
• 91 Mazziotti S, Gaeta M, Costa C et al.. Computed tomography features of liparitosis: a pneumoconiosis due to amorphous silica.  Eur Respir J. 2004;  23 208-213
• 92 Zeren E H, Colby T V, Roggli V L. Silica-induced pleural disease: an unusual case mimicking malignant mesothelioma.  Chest. 1997;  112 1436-1438
• 93 Young Jr R C, Rachal R E, Carr P G, Press H C. Patterns of coal workers' pneumoconiosis in Appalachian former coal miners.  J Natl Med Assoc. 1992;  84 41-48
• 94 Chapman S J, Cookson W O, Musk A W, Lee Y C. Benign asbestos pleural diseases.  Curr Opin Pulm Med. 2003;  9 266-271
• 95 Batra P, Brown K, Hayashi K, Mori M. Rounded atelectasis.  J Thorac Imaging. 1996;  11 187-197
• 96 Szydlowski G W, Cohn H E, Steiner R M, Edie R N. Rounded atelectasis: a pulmonary pseudotumor.  Ann Thorac Surg. 1992;  53 817-821
• 97 Jaurand M C, Fleury-Feith J. Pathogenesis of malignant pleural mesothelioma.  Respirology. 2005;  10 2-8
• 98 Marchevsky A M, Wick M R. Current controversies regarding the role of asbestos exposure in the causation of malignant mesothelioma: the need for an evidence-based approach to develop medicolegal guidelines.  Ann Diagn Pathol. 2003;  7 321-332
• 99 Donaldson K, Murphy F A, Duffin R, Poland C A. Asbestos, carbon nanotubes and the pleural mesothelium: a review of the hypothesis regarding the role of long fibre retention in the parietal pleura, inflammation and mesothelioma.  Part Fibre Toxicol. 2010;  7 5
• 100 Heintz N H, Janssen-Heininger Y M, Mossman B T. Asbestos, lung cancers, and mesotheliomas: from molecular approaches to targeting tumor survival pathways.  Am J Respir Cell Mol Biol. 2010;  42 133-139
• 101 Bourdès V, Boffetta P, Pisani P. Environmental exposure to asbestos and risk of pleural mesothelioma: review and meta-analysis.  Eur J Epidemiol. 2000;  16 411-417
• 102 Borow M, Conston A, Livornese L L, Schalet N. Mesothelioma and its association with asbestosis.  JAMA. 1967;  201 587-591
• 103 Borow M, Conston A, Livornese L, Schalet N. Mesothelioma following exposure to asbestos: a review of 72 cases.  Chest. 1973;  64 641-646
• 104 Connelly R R, Spirtas R, Myers M H, Percy C L, Fraumeni Jr J F. Demographic patterns for mesothelioma in the United States.  J Natl Cancer Inst. 1987;  78 1053-1060
• 105 Nishimura S L, Broaddus V C. Asbestos-induced pleural disease.  Clin Chest Med. 1998;  19 311-329
• 106 Peto J, Decarli A, La Vecchia C, Levi F, Negri E. The European mesothelioma epidemic.  Br J Cancer. 1999;  79 666-672
• 107 Peto J, Hodgson J T, Matthews F E, Jones J R. Continuing increase in mesothelioma mortality in Britain.  Lancet. 1995;  345 535-539
• 108 Treasure T, Waller D, Swift S, Peto J. Radical surgery for mesothelioma.  BMJ. 2004;  328 237-238
• 109 Kaufman A J, Pass H I. Current concepts in malignant pleural mesothelioma.  Expert Rev Anticancer Ther. 2008;  8 293-303
• 110 Lanphear B P, Buncher C R. Latent period for malignant mesothelioma of occupational origin.  J Occup Med. 1992;  34 718-721
• 111 Ohar J, Sterling D A, Bleecker E, Donohue J. Changing patterns in asbestos-induced lung disease.  Chest. 2004;  125 744-753
• 112 Legha S S, Muggia F M. Pleural mesothelioma: clinical features and therapeutic implications.  Ann Intern Med. 1977;  87 613-621
• 113 Brenner J, Sordillo P P, Magill G B, Golbey R B. Malignant mesothelioma of the pleura: review of 123 patients.  Cancer. 1982;  49 2431-2435
• 114 Adams V I, Unni K K, Muhm J R, Jett J R, Ilstrup D M, Bernatz P E. Diffuse malignant mesothelioma of pleura: diagnosis and survival in 92 cases.  Cancer. 1986;  58 1540-1551
• 115 Elmes P C, Simpson J C. The clinical aspects of mesothelioma.  Q J Med. 1976;  45 427-449
• 116 Crotty T B, Myers J L, Katzenstein A L, Tazelaar H D, Swensen S J, Churg A. Localized malignant mesothelioma: a clinicopathologic and flow cytometric study.  Am J Surg Pathol. 1994;  18 357-363
• 117 Allen T C, Cagle P T, Churg A M et al.. Localized malignant mesothelioma.  Am J Surg Pathol. 2005;  29 866-873
• 118 van Ruth S, Baas P, Zoetmulder F A. Surgical treatment of malignant pleural mesothelioma: a review.  Chest. 2003;  123 551-561
• 119 Butnor K J, Sporn T A, Hammar S P, Roggli V L. Well-differentiated papillary mesothelioma.  Am J Surg Pathol. 2001;  25 1304-1309
• 120 Hammar S P, Bolen J W. Sarcomatoid pleural mesothelioma.  Ultrastruct Pathol. 1985;  9 337-343
• 121 Klima M, Bossart M I. Sarcomatous type of malignant mesothelioma.  Ultrastruct Pathol. 1983;  4 349-358
• 122 Mangano W E, Cagle P T, Churg A, Vollmer R T, Roggli V L. The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: a histologic and immunohistochemical analysis of 31 cases including p53 immunostaining.  Am J Clin Pathol. 1998;  110 191-199
• 123 Attanoos R L, Gibbs A R. Pathology of malignant mesothelioma.  Histopathology. 1997;  30 403-418
• 124 Roggli V L, Kolbeck J, Sanfilippo F, Shelburne J D. Pathology of human mesothelioma: etiologic and diagnostic considerations.  Pathol Annu. 1987;  22(Pt 2) 91-131
• 125 Van Marck E. Pathology of malignant mesothelioma.  Lung Cancer. 2004;  45(Suppl 1) S35-S36
• 126 Corson J M. Pathology of mesothelioma.  Thorac Surg Clin. 2004;  14 447-460
• 127 Mark E J, Kradin R L. Pathological recognition of diffuse malignant mesothelioma of the pleura: the significance of the historical perspective as regards this signal tumor.  Semin Diagn Pathol. 2006;  23 25-34
• 128 O'Byrne K J, Edwards J G, Waller D A. Clinico-pathological and biological prognostic factors in pleural malignant mesothelioma.  Lung Cancer. 2004;  45(Suppl 1) S45-S48
• 129 Churg A, Colby T V, Cagle P et al.. The separation of benign and malignant mesothelial proliferations.  Am J Surg Pathol. 2000;  24 1183-1200
• 130 Cury P M, Butcher D N, Corrin B, Nicholson A G. The use of histological and immunohistochemical markers to distinguish pleural malignant mesothelioma and in situ mesothelioma from reactive mesothelial hyperplasia and reactive pleural fibrosis.  J Pathol. 1999;  189 251-257
• 131 Kutty C P, Remeniuk E, Varkey B. Malignant-appearing cells in pleural effusion due to pancreatitis: case report and literature review.  Acta Cytol. 1981;  25 412-416
• 132 Henderson D W, Shilkin K B, Whitaker D. Reactive mesothelial hyperplasia vs mesothelioma, including mesothelioma in situ: a brief review.  Am J Clin Pathol. 1998;  110 397-404
• 133 Bono F, Lombardi M. Prominent in situ component in a pleural malignant mesothelioma.  Int J Surg Pathol. 2010;  Jul 18. [Epub ahead of print]
• 134 Kaplan M A, Tazelaar H D, Hayashi T, Schroer K R, Travis W D. Adenomatoid tumors of the pleura.  Am J Surg Pathol. 1996;  20 1219-1223
• 135 Stout A P, Murray M R. Localized pleural mesothelioma.  Arch Pathol (Chic). 1942;  34 951-962
• 136 Briselli M, Mark E J, Dickersin G R. Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature.  Cancer. 1981;  47 2678-2689
• 137 Lu C, Ji Y, Shan F, Guo W, Ding J, Ge D. Solitary fibrous tumor of the pleura: an analysis of 13 cases.  World J Surg. 2008;  32 1663-1668
• 138 Saha S P. Solitary fibrous tumor of the pleura.  Int Surg. 2007;  92 351-354
• 139 Lee S C, Tzao C, Ou S M, Hsu H H, Yu C P, Cheng Y L. Solitary fibrous tumors of the pleura: clinical, radiological, surgical and pathological evaluation.  Eur J Surg Oncol. 2005;  31 84-87
• 140 Ordóñez N G. Localized (solitary) fibrous tumor of the pleura.  Adv Anat Pathol. 2000;  7 327-340
• 141 Moran C A, Suster S, Koss M N. The spectrum of histologic growth patterns in benign and malignant fibrous tumors of the pleura.  Semin Diagn Pathol. 1992;  9 169-180
• 142 England D M, Hochholzer L, McCarthy M J. Localized benign and malignant fibrous tumors of the pleura: a clinicopathologic review of 223 cases.  Am J Surg Pathol. 1989;  13 640-658
• 143 Flint A, Weiss S W. CD-34 and keratin expression distinguishes solitary fibrous tumor (fibrous mesothelioma) of pleura from desmoplastic mesothelioma.  Hum Pathol. 1995;  26 428-431
• 144 Butnor K J, Burchette J L, Sporn T A, Hammar S P, Roggli V L. The spectrum of Kit (CD117) immunoreactivity in lung and pleural tumors: a study of 96 cases using a single-source antibody with a review of the literature.  Arch Pathol Lab Med. 2004;  128 538-543
• 145 Gladish G W, Sabloff B M, Munden R F, Truong M T, Erasmus J J, Chasen M H. Primary thoracic sarcomas.  Radiographics. 2002;  22 621-637
• 146 Ognibene F P, Shelhamer J H. Kaposi's sarcoma.  Clin Chest Med. 1988;  9 459-465
• 147 Floris C, Sulis M L, Bernascani M, Turno R, Tedde A, Sulis E. Pneumothorax in pleuropulmonary Kaposi's sarcoma related to acquired immunodeficiency syndrome.  Am J Med. 1989;  87 123-124
• 148 O'Brien R F, Cohn D L. Serosanguineous pleural effusions in AIDS-associated Kaposi's sarcoma.  Chest. 1989;  96 460-466
• 149 Pandya K, Lal C, Tuchschmidt J, Boylen C T, Sharma O P. Bilateral chylothorax with pulmonary Kaposi's sarcoma.  Chest. 1988;  94 1316-1317
• 150 Yousem S A. Angiosarcoma presenting in the lung.  Arch Pathol Lab Med. 1986;  110 112-115
• 151 Bocklage T, Leslie K, Yousem S, Colby T. Extracutaneous angiosarcomas metastatic to the lungs: clinical and pathologic features of twenty-one cases.  Mod Pathol. 2001;  14 1216-1225
• 152 Lin B T, Colby T, Gown A M et al.. Malignant vascular tumors of the serous membranes mimicking mesothelioma: a report of 14 cases.  Am J Surg Pathol. 1996;  20 1431-1439
• 153 Falconieri G, Bussani R, Mirra M, Zanella M. Pseudomesotheliomatous angiosarcoma: a pleuropulmonary lesion simulating malignant pleural mesothelioma.  Histopathology. 1997;  30 419-424
• 154 Engleman P, Liebow A A, Gmelich J, Friedman P J. Pulmonary hyalinizing granuloma.  Am Rev Respir Dis. 1977;  115 997-1008
• 155 Yousem S A, Hochholzer L. Pulmonary hyalinizing granuloma.  Am J Clin Pathol. 1987;  87 1-6
• 156 Satti M B, Batouk A A, Abdelaziz M M, Ahmad M F, Abdelaal M A. Pulmonary hyalinizing granuloma: bilateral pulmonary nodules associated with chronic idiopathic thrombocytopenic purpura.  Saudi Med J. 2005;  26 1459-1463
• 157 Pinkard N B, Wilson R W, Lawless N et al.. Calcifying fibrous pseudotumor of pleura: a report of three cases of a newly described entity involving the pleura.  Am J Clin Pathol. 1996;  105 189-194
• 158 Jiang K, Nie J, Wang J, Li J. Multiple calcifying fibrous pseudotumor of the bilateral pleura.  Jpn J Clin Oncol. 2010;  Jul 9. [Epub ahead of print]
• 159 Shibata K, Yuki D, Sakata K. Multiple calcifying fibrous pseudotumors disseminated in the pleura.  Ann Thorac Surg. 2008;  85 e3-e5
• 160 Hainaut P, Lesage V, Weynand B, Coche E, Noirhomme P. Calcifying fibrous pseudotumor (CFPT): a patient presenting with multiple pleural lesions.  Acta Clin Belg. 1999;  54 162-164
• 161 Soyer T, Ciftci A O, Güçer S, Orhan D, Senocak M E. Calcifying fibrous pseudotumor of lung: a previously unreported entity.  J Pediatr Surg. 2004;  39 1729-1730
• 162 Sahn S A. Malignancy metastatic to the pleura.  Clin Chest Med. 1998;  19 351-361
• 163 Matthay R A, Coppage L, Shaw C, Filderman A E. Malignancies metastatic to the pleura.  Invest Radiol. 1990;  25 601-619
• 164 Husain A N, Colby T V, Ordóñez N G et al.. Guidelines for pathologic diagnosis of malignant mesothelioma: a consensus statement from the International Mesothelioma Interest Group.  Arch Pathol Lab Med. 2009;  133 1317-1331
• 165 Marchevsky A M, Wick M R. Evidence-based guidelines for the utilization of immunostains in diagnostic pathology: pulmonary adenocarcinoma versus mesothelioma.  Appl Immunohistochem Mol Morphol. 2007;  15 140-144
• 166 Attanoos R L, Gibbs A R. “Pseudomesotheliomatous” carcinomas of the pleura: a 10-year analysis of cases from the Environmental Lung Disease Research Group, Cardiff.  Histopathology. 2003;  43 444-452
• 167 Koss L G. Benign and malignant mesothelial proliferations.  Am J Surg Pathol. 2001;  25 548-549
• 168 Molinie V, Pouchot J, Navratil E, Aubert F, Vinceneux P, Barge J. Primary Epstein-Barr virus-related non-Hodgkin's lymphoma of the pleural cavity following long-standing tuberculous empyema.  Arch Pathol Lab Med. 1996;  120 288-291
• 169 Hengge U R, Ruzicka T, Tyring S K et al.. Update on Kaposi's sarcoma and other HHV8 associated diseases: II: Pathogenesis, Castleman's disease, and pleural effusion lymphoma.  Lancet Infect Dis. 2002;  2 344-352
• 170 Sunil M, Reid E, Lechowicz M J. Update on HHV-8-associated malignancies.  Curr Infect Dis Rep. 2010;  12 147-154
• 171 Carbone A, Cesarman E, Spina M, Gloghini A, Schulz T F. HIV-associated lymphomas and gamma-herpesviruses.  Blood. 2009;  113 1213-1224
• 172 Savage K J. Rare B-cell lymphomas: primary mediastinal, intravascular, and primary effusion lymphoma.  Cancer Treat Res. 2008;  142 243-264
• 173 Vu H N, Jenkins F W, Swerdlow S H, Locker J, Lotze M T. Pleural effusion as the presentation for primary effusion lymphoma.  Surgery. 1998;  123 589-591
• 174 Bhojawala J, Heller D S, Cracchiolo B, Sama J. Endometriosis presenting as bloody pleural effusion and ascites-report of a case and review of the literature.  Arch Gynecol Obstet. 2000;  264 39-41
• 175 Channabasavaiah A D, Joseph J V. Thoracic endometriosis: revisiting the association between clinical presentation and thoracic pathology based on thoracoscopic findings in 110 patients.  Medicine (Baltimore). 2010;  89 183-188
• 176 Charles D. Endometriosis and hemorrhagic pleural effusion.  Obstet Gynecol. 1957;  10 309-312
• 177 Dhanaworavibul K, Hanprasertpong J, Cheewadhanaraks S, Buhachat R. Bilateral pleural endometriosis.  J Obstet Gynaecol Res. 2006;  32 86-89
• 178 El Ghazal R, Fabian T, Ahmed Z A, Moritz E D. Thoracic endometriosis: an unusual cause of hemothorax.  Conn Med. 2009;  73 453-456
• 179 Johnson M M. Catamenial pneumothorax and other thoracic manifestations of endometriosis.  Clin Chest Med. 2004;  25 311-319
• 180 McKeen S, Dharsono F. Thoracic splenosis: diagnosis of a case based on history and computerized tomography findings.  Australas Radiol. 2007;  51(Suppl) B246-B249
• 181 Yammine J N, Yatim A, Barbari A. Radionuclide imaging in thoracic splenosis and a review of the literature.  Clin Nucl Med. 2003;  28 121-123
• 182 Ruffini E, Asioli S, Filosso P L et al.. Intrathoracic splenosis: a case report and an update of invasive and noninvasive diagnostic techniques.  J Thorac Cardiovasc Surg. 2007;  134 1594-1595
• 183 Papakonstantinou C, Christoforidis E, Vasiliadis K, Kanellos I, Zarogoulidis K. Thoracic splenosis twenty-nine years after traumatic splenectomy mimicking intrathoracic neoplasm.  Eur Surg Res. 2005;  37 76-78
• 184 Kim K, Choi H J, Kim Y M, Kwon W J, Lee W C, Suh J H. Thoracic splenosis: a case report and the importance of clinical history.  J Korean Med Sci. 2010;  25 299-303
• 185 Khan A M, Manzoor K, Gordon D, Berman A. Thoracic splenosis: a diagnosis by history and imaging.  Respirology. 2008;  13 481-483
• 186 Gaines J J, Crosby J H, Vinayak Kamath M. Diagnosis of thoracic splenosis by tru-cut needle biopsy.  Am Rev Respir Dis. 1986;  133 1199-1201
• 187 Looi L M. The pattern of amyloid deposition in the lung.  Malays J Pathol. 1999;  21 29-35
• 188 Knapp M J, Roggli V L, Kim J, Moore J O, Shelburne J D. Pleural amyloidosis.  Arch Pathol Lab Med. 1988;  112 57-60
• 189 Granel B, Serratrice J, Disdier P, Weiller P J, Astoul P. Systemic amyloidosis with pleural involvement.  Am J Med. 2003;  115 742-743
• 190 Graham D R, Ahmad D. Amyloidosis with pleural involvement.  Eur Respir J. 1988;  1 571-572
• 191 Bridges K G, Welch G, Silver M, Schinco M A, Esposito B. CT detection of occult pneumothorax in multiple trauma patients.  J Emerg Med. 1993;  11 179-186
• 192 Hill S L, Edmisten T, Holtzman G, Wright A. The occult pneumothorax: an increasing diagnostic entity in trauma.  Am Surg. 1999;  65 254-258
• 193 Henderson S O, Shoenberger J M. Anterior pneumothorax and a negative chest X-ray in trauma.  J Emerg Med. 2004;  26 231-232
• 194 Misthos P, Kakaris S, Sepsas E, Athanassiadi K, Skottis I. A prospective analysis of occult pneumothorax, delayed pneumothorax and delayed hemothorax after minor blunt thoracic trauma.  Eur J Cardiothorac Surg. 2004;  25 859-864
• 195 Peguero F A, Netzman A. Bullous emphysema and pneumothorax.  J Med Soc N J. 1985;  82 743-745
• 196 DeVries W C, Wolfe W G. The management of spontaneous pneumothorax and bullous emphysema.  Surg Clin North Am. 1980;  60 851-866
• 197 Beers M F, Sohn M, Swartz M. Recurrent pneumothorax in AIDS patients with Pneumocystis pneumonia: a clinicopathologic report of three cases and review of the literature.  Chest. 1990;  98 266-270
• 198 Pastores S M, Garay S M, Naidich D P, Rom W N. Review: pneumothorax in patients with AIDS-related Pneumocystis carinii pneumonia.  Am J Med Sci. 1996;  312 229-234
• 199 Tumbarello M, Tacconelli E, Pirronti T, Cauda R, Ortona L. Pneumothorax in HIV-infected patients: role of Pneumocystis carinii pneumonia and pulmonary tuberculosis.  Eur Respir J. 1997;  10 1332-1335
• 200 Mendez J L, Nadrous H F, Vassallo R, Decker P A, Ryu J H. Pneumothorax in pulmonary Langerhans cell histiocytosis.  Chest. 2004;  125 1028-1032
• 201 Bearz A, Rupolo M, Canzonieri V et al.. Lymphangioleiomyomatosis: a case report and review of the literature.  Tumori. 2004;  90 528-531
• 202 Flume P A. Pneumothorax in cystic fibrosis.  Chest. 2003;  123 217-221
• 203 Noppen M, Baumann M H. Pathogenesis and treatment of primary spontaneous pneumothorax: an overview.  Respiration. 2003;  70 431-438
• 204 Sassoon C S, Light R W, O'Hara V S, Moritz T E. Iatrogenic pneumothorax: etiology and morbidity: results of a Department of Veterans Affairs Cooperative Study.  Respiration. 1992;  59 215-220
• 205 Despars J A, Sassoon C S, Light R W. Significance of iatrogenic pneumothoraces.  Chest. 1994;  105 1147-1150
• 206 Smith P R, Nacht R I. Drug-induced lupus pleuritis mimicking pleural space infection.  Chest. 1992;  101 268-269
• 207 Good Jr J T, King T E, Antony V B, Sahn S A. Lupus pleuritis: clinical features and pleural fluid characteristics with special reference to pleural fluid antinuclear antibodies.  Chest. 1983;  84 714-718
• 208 Graham W R. Rheumatoid pleuritis.  South Med J. 1990;  83 973-975
• 209 Owens M W, Milligan S A. Pleuritis and pleural effusions.  Curr Opin Pulm Med. 1995;  1 318-323
• 210 Chou C W, Chang S C. Pleuritis as a presenting manifestation of rheumatoid arthritis: diagnostic clues in pleural fluid cytology.  Am J Med Sci. 2002;  323 158-161
• 211 Morelock S Y, Sahn S A. Drugs and the pleura.  Chest. 1999;  116 212-221
• 212 Mandal A K, Thadepalli H, Mandal A K, Chettipalli U. Posttraumatic empyema thoracis: a 24-year experience at a major trauma center.  J Trauma. 1997;  43 764-771
• 213 Kaye M D. Pleuropulmonary complications of pancreatitis.  Thorax. 1968;  23 297-306
• 214 Saugier B, Emonot A, Berard P, Faguer P, Galy P. Pleuresies in chronic pancreatitis and in pancreatic pseudocysts: a study apropos of 20 cases.  [in French] Poumon Coeur. 1976;  32 233-240
• 215 Fentanes de Torres E, Guevara E. Pleuritis by radiation: reports of two cases.  Acta Cytol. 1981;  25 427-429
• 216 Shrivastava R, Venkatesh S, Pavlovich B B, Bharadwaj J, Vaz A. Immunological analysis of pleural fluid in post-cardiac injury syndrome.  Postgrad Med J. 2002;  78 362-363
• 217 Vallyathan N V, Green F H, Craighead J E. Recent advances in the study of mineral pneumoconiosis.  Pathol Annu. 1980;  15(Pt 2) 77-104
• 218 Maher J F. Uremic pleuritis.  Am J Kidney Dis. 1987;  10 19-22
• 219 Yoshii C, Morita S, Tokunaga M et al.. Bilateral massive pleural effusions caused by uremic pleuritis.  Intern Med. 2001;  40 646-649
• 220 Hage C A, abdul-Mohammed K, Antony V B. Pathogenesis of pleural infection.  Respirology. 2004;  9 12-15
• 221 Oba S, Akuma M. Localized bilateral empyema caused by spontaneous esophageal rupture.  [in Japanese] Rinsho Hoshasen. 1985;  30 395-396
• 222 Sees D W, Obney J A, Tripp H F. Empyema complicating muscle-sparing thoracotomy: the role of wound management.  Am Surg. 2002;  68 390-391
• 223 Irving A D, Turner M A. Pleural empyema in association with renal sepsis.  Br J Surg. 1976;  63 70-72
• 224 Clarridge J, Roberts C, Peters J, Musher D. Sepsis and empyema caused by Yersinia enterocolitica .  J Clin Microbiol. 1983;  17 936-938
• 225 Ballantyne K C, Sethia B, Reece I J, Davidson K G. Empyema following intra-abdominal sepsis.  Br J Surg. 1984;  71 723-725
• 226 Iscovich A L, Salvucci A A. Streptococcal sepsis and death caused by empyema.  Am J Emerg Med. 1986;  4 28-30
• 227 Samelson S L, Ferguson M K. Empyema following percutaneous catheter drainage of upper abdominal abscess.  Chest. 1992;  102 1612-1614
• 228 Ellman P, Cudkowicz L, Elwood J S. Widespread serous membrane involvement by rheumatoid nodules.  J Clin Pathol. 1954;  7 239-244
• 229 Jurik A G, Graudal H. Pleurisy in rheumatoid arthritis.  Scand J Rheumatol. 1983;  12 75-80
• 230 Robinson A C, Power J, Clancy L, Sweeney E. Recurrent pneumothorax in rheumatoid arthritis.  Ir J Med Sci. 1984;  153 437-438
• 231 Engel U, Aru A, Francis D. Rheumatoid pleurisy: specificity of cytological findings.  Acta Pathol Microbiol Immunol Scand [A]. 1986;  94 53-56
• 232 Anaya J M, Diethelm L, Ortiz L A et al.. Pulmonary involvement in rheumatoid arthritis.  Semin Arthritis Rheum. 1995;  24 242-254
• 233 Pines A, Kaplinsky N, Olchovsky D, Rozenman J, Frankl O. Pleuro-pulmonary manifestations of systemic lupus erythematosus: clinical features of its subgroups. Prognostic and therapeutic implications.  Chest. 1985;  88 129-135
• 234 Wang D Y, Chang D B, Kuo S H et al.. Systemic lupus erythematosus presenting as pleural effusion: report of a case.  J Formos Med Assoc. 1995;  94 746-749
• 235 Wang D Y. Diagnosis and management of lupus pleuritis.  Curr Opin Pulm Med. 2002;  8 312-316
• 236 Quismorio Jr F P. Pulmonary involvement in primary Sjögren's syndrome.  Curr Opin Pulm Med. 1996;  2 424-428
• 237 Kawamata K, Haraoka H, Hirohata S, Hashimoto T, Jenkins R N, Lipsky P E. Pleurisy in primary Sjögren's syndrome: T cell receptor beta-chain variable region gene bias and local autoantibody production in the pleural effusion.  Clin Exp Rheumatol. 1997;  15 193-196
• 238 Weir I H, Müller N L, Chiles C, Godwin J D, Lee S H, Kullnig P. Wegener's granulomatosis: findings from computed tomography of the chest in 10 patients.  Can Assoc Radiol J. 1992;  43 31-34
• 239 Kuhlman J E, Hruban R H, Fishman E K. Wegener granulomatosis: CT features of parenchymal lung disease.  J Comput Assist Tomogr. 1991;  15 948-952
• 240 Maguire R, Fauci A S, Doppman J L, Wolff S M. Unusual radiographic features of Wegener's granulomatosis.  AJR Am J Roentgenol. 1978;  130 233-238
• 241 Craighead J E, Mossman B T, Bradley B J. Comparative studies on the cytotoxicity of amphibole and serpentine asbestos.  Environ Health Perspect. 1980;  34 37-46
• 242 Hendry N. The geologic occurrences and major uses of asbestos.  Ann NY Acad Sci. 1965;  132 12-21
• 243 Clover J, Oates J, Edwards C. Anti-cytokeratin 5/6: a positive marker for epithelioid mesothelioma.  Histopathology. 1997;  31 140-143
• 244 Ordóñez N G. Value of cytokeratin 5/6 immunostaining in distinguishing epithelial mesothelioma of the pleura from lung adenocarcinoma.  Am J Surg Pathol. 1998;  22 1215-1221
• 245 Dei Tos A P, Doglioni C. Calretinin: a novel tool for diagnostic immunohistochemistry.  Adv Anat Pathol. 1998;  5 61-66
• 246 Ordóñez N G. Value of calretinin immunostaining in differentiating epithelial mesothelioma from lung adenocarcinoma.  Mod Pathol. 1998;  11 929-933
• 247 Ordóñez N G. The immunohistochemical diagnosis of mesothelioma: a comparative study of epithelioid mesothelioma and lung adenocarcinoma.  Am J Surg Pathol. 2003;  27 1031-1051
• 248 Ordóñez N G. The value of antibodies 44-3A6, SM3, HBME-1, and thrombomodulin in differentiating epithelial pleural mesothelioma from lung adenocarcinoma: a comparative study with other commonly used antibodies.  Am J Surg Pathol. 1997;  21 1399-1408
• 249 González-Lois C, Ballestín C, Sotelo M T, López-Ríos F, García-Prats M D, Villena V. Combined use of novel epithelial (MOC-31) and mesothelial (HBME-1) immunohistochemical markers for optimal first line diagnostic distinction between mesothelioma and metastatic carcinoma in pleura.  Histopathology. 2001;  38 528-534
• 250 Gümürdülü D, Zeren E H, Cagle P T et al.. Specificity of MOC-31 and HBME-1 immunohistochemistry in the differential diagnosis of adenocarcinoma and malignant mesothelioma: a study on environmental malignant mesothelioma cases from Turkish villages.  Pathol Oncol Res. 2002;  8 188-193
• 251 Foster M R, Johnson J E, Olson S J, Allred D C. Immunohistochemical analysis of nuclear versus cytoplasmic staining of WT1 in malignant mesotheliomas and primary pulmonary adenocarcinomas.  Arch Pathol Lab Med. 2001;  125 1316-1320
• 252 al-Saffar N, Hasleton P S. Vimentin, carcinoembryonic antigen and keratin in the diagnosis of mesothelioma, adenocarcinoma and reactive pleural lesions.  Eur Respir J. 1990;  3 997-1001
• 253 Duggan M A, Masters C B, Alexander F. Immunohistochemical differentiation of malignant mesothelioma, mesothelial hyperplasia and metastatic adenocarcinoma in serous effusions, utilizing staining for carcinoembryonic antigen, keratin and vimentin.  Acta Cytol. 1987;  31 807-814
• 254 Wang N S, Huang S N, Gold P. Absence of carcinoembryonic antigen-like material in mesothelioma: an immunohistochemical differentiation from other lung cancers.  Cancer. 1979;  44 937-943
• 255 Riera J R, Astengo-Osuna C, Longmate J A, Battifora H. The immunohistochemical diagnostic panel for epithelial mesothelioma: a reevaluation after heat-induced epitope retrieval.  Am J Surg Pathol. 1997;  21 1409-1419
• 256 Khoor A, Whitsett J A, Stahlman M T, Olson S J, Cagle P T. Utility of surfactant protein B precursor and thyroid transcription factor 1 in differentiating adenocarcinoma of the lung from malignant mesothelioma.  Hum Pathol. 1999;  30 695-700
• 257 Ordóñez N G. Value of thyroid transcription factor-1, E-cadherin, BG8, WT1, and CD44S immunostaining in distinguishing epithelial pleural mesothelioma from pulmonary and nonpulmonary adenocarcinoma.  Am J Surg Pathol. 2000;  24 598-606
• 258 Gaffey M J, Mills S E, Swanson P E, Zarbo R J, Shah A R, Wick M R. Immunoreactivity for BER-EP4 in adenocarcinomas, adenomatoid tumors, and malignant mesotheliomas.  Am J Surg Pathol. 1992;  16 593-599
• 259 Ordóñez N G. Value of the Ber-EP4 antibody in differentiating epithelial pleural mesothelioma from adenocarcinoma: the M.D. Anderson experience and a critical review of the literature.  Am J Clin Pathol. 1998;  109 85-89
• 260 Ordóñez N G. Value of the MOC-31 monoclonal antibody in differentiating epithelial pleural mesothelioma from lung adenocarcinoma.  Hum Pathol. 1998;  29 166-169
• 261 Comin C E, Novelli L, Boddi V, Paglierani M, Dini S. Calretinin, thrombomodulin, CEA, and CD15: a useful combination of immunohistochemical markers for differentiating pleural epithelial mesothelioma from peripheral pulmonary adenocarcinoma.  Hum Pathol. 2001;  32 529-536
• 262 Szpak C A, Johnston W W, Roggli V et al.. The diagnostic distinction between malignant mesothelioma of the pleura and adenocarcinoma of the lung as defined by a monoclonal antibody (B72.3).  Am J Pathol. 1986;  122 252-260
• 263 Warnock M L, Stoloff A, Thor A. Differentiation of adenocarcinoma of the lung from mesothelioma: periodic acid-Schiff, monoclonal antibodies B72.3, and Leu M1.  Am J Pathol. 1988;  133 30-38
• 264 Saad R S, Lindner J L, Lin X, Liu Y L, Silverman J F. The diagnostic utility of D2-40 for malignant mesothelioma versus pulmonary carcinoma with pleural involvement.  Diagn Cytopathol. 2006;  34 801-806