Localized primary tumors of the pleura: an analysis of 40 cases

A study of 40 localized primary tumors of the pleura in the files of the Canadian Tumour Reference Centre revealed a considerable diversity in their histologic structure. Collagenized, hemangiopericytoma-like and cellular areas were the main forms of growth pattern, with half of the tumors showing a mixture of two or more of these elements. Inclusions of non-neoplastic bronchioloalveolar epithelium were frequently seen in areas of tumor adjacent to lung substance but in only one tumor was there a neoplastic component of epithelial form. Eight tumors (20%) showed evidence of malignant behavior. All of these were large and cellular at the time of initial surgery and four had mitotic counts of 10 or more/10 H.P.F. in areas. The evidence suggests that the great majority of localized pleural tumors arise from submesothelial mesenchymal elements and it is believed that the term mesothelioma should not be used in reference to these growths.