Pleural Granuloma Mimicking Malignancy 42 Years after Slurry Talc Injection for Primary Spontaneous Pneumothorax

Tenconi, Sara; Luzzi, Luca; Paladini, Piero; Voltolini, Luca; Gallazzi, M.; Granato, Felice; Gotti, Giuseppe

doi:10.1159/000313503

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…There are some large series with significant number of patients in past however those studies include PET only estimation however it is important to determine recent PET/CT scanners' results. As an example talc pleurodesis is another important reason of false positive FDG uptake in pleural plaques that can be discriminated by means of correlation with CT appearance (21,22). Additionally this study has superiority of having CT scan comparison with estimation of a different observer and advantage of the same time study for PET/CT and CT.…”

Section: Discussionmentioning

confidence: 87%

The F-18 FDG PET/CT and CT evaluation of pleural plaques

et al. 2019

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The F-18 Fdg PeT/cT and cT evaluation of pleural plaques Introduction: Pleural plaques have the possibility of bearing malignancy thus investigation of this entity is important and the most important indicator of malignancy in general is fluorodeoxyglucose (FDG) accumulation in radiological appearance. However there is discrepancy between results of previous studies in the literature about this subject. The aim of this study is to analyze the standardized uptake value of pleural plaques and the cut off levels for malignancy in comparison with computed tomography (CT). Materials and Methods: Seventy one patients were included in the study (27F, 44M; mean: 59.9 ± 13.1 years). Oncologic F-18 FDG positron emission tomography/computed tomography (PET/CT) was performed to all the subjects for a different primary tumor. Pleural plaques were identified in all patients in CT component of PET/CT examination. Contrast enhanced and nonenhanced CT images were evaluated by a Radiology Physician independently according to the gold standard pathology. results: The diagnostic sensitivity, specificity of CT was; 39%, 79% respectively and if the cutoff SUV max level was accepted "4.8" the diagnostic sensitivity and specificity of PET was 71%, and 63% respectively.

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Section: Discussionmentioning

confidence: 87%

The F-18 FDG PET/CT and CT evaluation of pleural plaques

et al. 2019

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“…The granulomas may arise many years after the initial trauma or procedure in the form of tumor-like soft-tissue masses [26][27][28]. Multiple studies have indicated that lesions of active inflammation and infection may have higher 18 FDG activity on DTPI, similar to that in malignant lesions, thus resulting in suboptimal diagnostic performance of DTPI [29][30][31].…”

Section: Resultsmentioning

confidence: 99%

Dual-time point 18FDG-PET/CT imaging may be useful in assessing local recurrent disease in high grade bone and soft tissue sarcoma

Dancheva

Bochev²,

Chaushev³

et al. 2016

Nucl. Med. Rev.

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“…Acute events have been reported following pleurodesis including: fever, chest pain, hypoxemia, dyspnea, hypotension, lipothymia and less commonly hypercalcemia along with acute respiratory distress syndrome ( 25 ). As well, chronic events have also been reported including granulomas, pleural thickening, mesotheliod reaction and pulmonary nodules ( 6 – 8 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

“…To date, most studies on humans have focused on assessing the clinical outcome exclusively, therein reporting only on short-term complications (often in severely symptomatic patients from a respiratory disease) while investigations on long-term complications have been few and mostly describing single cases ( 6 – 8 ). Limited available data on possible long term complications associated with talc pleurodesis are available in the Literature ( 2 , 3 , 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Observational analysis on inflammatory reaction to talc pleurodesis: Small and large animal model series review

et al. 2017

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Talc pleurodesis has been associated with pleuropulmonary damage, particularly long-term damage due to its inert nature. The present model series review aimed to assess the safety of this procedure by examining inflammatory stimulus, biocompatibility and tissue reaction following talc pleurodesis. Talc slurry was performed in rabbits: 200 mg/kg checked at postoperative day 14 (five models), 200 mg/kg checked at postoperative day 28 (five models), 40 mg/kg, checked at postoperative day 14 (five models), 40 mg/kg checked at postoperative day 28 (five models). Talc poudrage was performed in pigs: 55 mg/kg checked at postoperative day 60 (18 models). Tissue inspection and data collection followed the surgical pathology approach currently used in clinical practice. As this was an observational study, no statistical analysis was performed. Regarding the rabbit model (Oryctolagus cunicoli), the extent of adhesions ranged between 0 and 30%, and between 0 and 10% following 14 and 28 days, respectively. No intraparenchymal granuloma was observed whereas, pleural granulomas were extensively encountered following both talc dosages, with more evidence of visceral pleura granulomas following 200 mg/kg compared with 40 mg/kg. Severe florid inflammation was observed in 2/10 cases following 40 mg/kg. Parathymic, pericardium granulomas and mediastinal lymphadenopathy were evidenced at 28 days. At 60 days, from rare adhesions to extended pleurodesis were observed in the pig model (Sus Scrofa domesticus). Pleural granulomas were ubiquitous on visceral and parietal pleurae. Severe spotted inflammation among the adhesions were recorded in 15/18 pigs. Intraparenchymal granulomas were observed in 9/18 lungs. Talc produced unpredictable pleurodesis in both animal models with enduring pleural inflammation whether it was performed via slurry or poudrage. Furthermore, talc appeared to have triggered extended pleural damage, intraparenchymal nodules (porcine poudrage) and mediastinal migration (rabbit slurry).

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Pleural Granuloma Mimicking Malignancy 42 Years after Slurry Talc Injection for Primary Spontaneous Pneumothorax

Cited by 7 publications

References 19 publications

The F-18 FDG PET/CT and CT evaluation of pleural plaques

The F-18 FDG PET/CT and CT evaluation of pleural plaques

Dual-time point 18FDG-PET/CT imaging may be useful in assessing local recurrent disease in high grade bone and soft tissue sarcoma

Observational analysis on inflammatory reaction to talc pleurodesis: Small and large animal model series review

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