Imaging the pleura

Successful ultrasound imaging of pulmonary sub-pleural hamartoma

Pulmonary hamartoma, a common benign tumor of the lung, often presents as a solitary nodule on the peripheral lung, and is mainly composed of bronchial mucosa epithelial cells, chondrocytes, and adipose cells. Here, we report the case of a 42-year-old female who had a lung nodule that appeared as a homogeneous high-density shadow of a peripheral localization on chest computed tomography scan. For further evaluation, transthoracic ultrasonography examination was performed, which revealed a round, heterogenous, hypoechoic mass attached to the visceral pleura and showing obvious respiratory motions on the real-time ultrasonic images. Video-assisted thoracoscopic operation with ultrasound marking was performed, and a tumor 1.5 × 1.0 cm in size was successfully removed from this patient. The pathohistological diagnosis was pulmonary hamartoma, and the patient was successfully cured.

Diagnostic and prognostic value of soluble syndecan-1 in pleural malignancies

Background. The distinction between malignant and benign pleural effusions is a diagnostic challenge today and measuring soluble biomarkers could add to the diagnostic accuracy. Syndecan-1 is a proteoglycan involved in various cellular functions and is cleaved from the cell surface in a regulated manner. The shed fragment, which can be recovered in effusion supernatant and in serum, retains its binding capacities, but often with different functions and signalling properties than the cell-bound form. Aim. This study aimed to investigate the diagnostic and prognostic value of soluble syndecan-1 in pleural effusions and sera from patients with pleural malignancies. Study Design. Using two cohorts of patients, we assessed the diagnostic and prognostic value of soluble syndecan-1 in pleural effusions and sera, using enzyme-linked immunosorbent assays. Results. In pleural effusions, syndecan-1 distinguished malignant and benign diseases, with an odds ratio of 8.59 (95% CI 3.67 to 20.09). Furthermore, syndecan-1 in pleural effusions predicted a survival difference for patients with pleural metastatic disease and malignant mesothelioma of 11.2 and 9.2 months, respectively. However, no such effects were seen when syndecan-1 was measured in serum. Conclusion. Soluble syndecan-1 is a promising candidate biomarker for the cytopathological diagnosis and prognostication of malignant pleural effusions.