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Pleural Effusion I: Introduction01:25

Pleural Effusion I: Introduction

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Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
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Pleural Effusion II: Symptoms and Management01:28

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Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
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Pleural Disorders: Types and Brief Description01:30

Pleural Disorders: Types and Brief Description

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The pleura is a vital part of the respiratory system. It's a double-layered membrane surrounding the lungs and lining the chest cavity. The two layers of the pleura are:
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Pleura of the Lungs01:13

Pleura of the Lungs

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The lungs are nestled in a cavity, shielded by the pleura. The pleura, a form of serous membrane, wraps around each lung. This membrane arrangement consists of two layers: the visceral and parietal pleurae. The visceral pleura lines the surface of the lungIn contrast, the parietal pleura is the outer layer and contacts to the thoracic wall, the mediastinum, and the diaphragm. The hilum is the point of connection between the visceral and parietal layers. The space between the parietal and...
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Pulmonary Embolism I: Introduction01:29

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pleural effusion in hematological pathology.

Neeraja Yerrapotu1, Abid Rahman1, Ali Gabali1

  • 1Department of Pathology, Detroit Medical Center, Karmanos Cancer Center and Wayne State University School of Medicine, Detroit, Michigan, United States.

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Summary

This study details a patient with chronic myelomonocytic leukemia-2 (CMML-2) who developed atypical cells in pleural fluid. Immunostains helped differentiate these cells, aiding diagnosis.

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Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Chronic myelomonocytic leukemia-2 (CMML-2) is a myeloid malignancy.
  • Pleural effusions can occur in patients with hematologic malignancies.

Observation:

  • A 51-year-old male with CMML-2 presented with symptoms of pleural effusion.
  • Computed tomography revealed right-sided pleural effusion and atelectasis.
  • Pleural fluid cytology identified atypical cells alongside reactive mesothelial cells.

Findings:

  • Immunohistochemical staining using the SCIP approach was performed on atypical cells.
  • Atypical cells were positive for vimentin, CD68, and CD163.
  • Atypical cells were negative for cytokeratin, calretinin, BerEP4, and MOC31, suggesting a non-mesothelial, non-epithelial origin.

Implications:

  • These findings aid in the differential diagnosis of pleural effusions in CMML-2 patients.
  • Immunostaining patterns are crucial for accurate tumor classification.
  • Further research may elucidate the specific nature and origin of these atypical cells.