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[Pleuritis in yellow nail syndrome].
C A Kossakowski1, P Schmiegelow, K-M Müller
1Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland. claudia.kossakowski@ukmuenster.de
Der Pathologe
|November 4, 2011
Summary
Yellow nail syndrome can cause massive pleural effusion, leading to thickened pleura and abnormal blood vessel growth. Histopathology revealed chronic inflammation and edema, but no lymphatic vessel abnormalities.
Area of Science:
- Pulmonology
- Pathology
- Immunology
Background:
- Yellow nail syndrome (YNS) is a rare disorder characterized by lymphedema, dystrophic nails, and respiratory issues.
- Pleural effusion is a common respiratory manifestation of YNS, often leading to significant morbidity.
Observation:
- A 76-year-old male with YNS presented with cough and dyspnea due to massive pleural effusion.
- Radiological diagnosis confirmed massive pleural effusion.
- Lung biopsy was performed for histopathological examination.
Findings:
- Histopathology showed chronic non-specific pleuritis with significant intrapleural edema and eightfold pleural thickening.
- Angiogenesis was observed in intrapleural blood vessels.
- No lymphatic vessel abnormalities were detected by D2-40 immunohistochemistry.
- Granulomatous foreign body reaction was noted, attributed to talc pleurodesis therapy.
Implications:
- The findings suggest that chronic inflammation, increased vascular permeability, and angiogenesis contribute to massive pleural effusion in YNS.
- Lymphatic vessel abnormalities were not confirmed as a primary cause in this case.
- These pleural changes may be secondary to chronic infections, immunological inflammation, or paraneoplastic processes.
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