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Silica-Induced Pleural Disease : An Unusual Case Mimicking Malignant Mesothelioma

E. Handan Zeren; Thomas V. Colby; Victor L. Roggli
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Affiliations: From the Department of Pathology, Cukurova University, Balcali, Adana, Turkey,  From the Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz,  From the Department of Pathology, Duke University Medical Center, Durham, NC.

Affiliations: From the Department of Pathology, Cukurova University, Balcali, Adana, Turkey,  From the Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz,  From the Department of Pathology, Duke University Medical Center, Durham, NC.

Affiliations: From the Department of Pathology, Cukurova University, Balcali, Adana, Turkey,  From the Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz,  From the Department of Pathology, Duke University Medical Center, Durham, NC.


1997 by the American College of Chest Physicians


Chest. 1997;112(5):1436-1438. doi:10.1378/chest.112.5.1436
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Abstract

A 57-year-old man with a history of exposure to silica for 32 years presented with pleural thickening of the lower lobe of the left lung and a chronic right-sided pleural effusion without any radiographic evidence of parenchymal nodules in either lung. Light microscopic examination of a left visceral pleural biopsy specimen revealed markedly thickened pleura with fibrosis and macrophages containing birefringent silica and silicates. Occasional rounded intrapleural silicotic nodules were present. The underlying lung tissue did not show fibrosis or silicotic nodules. An energy-dispersive x-ray analysis confirmed the presence of silica. In the absence of lung involvement, this case represents a very unusual pathologic reaction caused by silica and silicates and adds to the clinical differential diagnosis of chronic pleuritis and malignant mesothelioma.


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