Nodular histiocytic/mesothelial hyperplasia as consequence of chronic mesothelium irritation by subphrenic abscess.
PURPOSE
Pleural nodular histiocytic/mesothelial hyperplasia is a nodular histiocytic/mesothelial proliferation, often delimiting cystic cavities, due to irritation by a pulmonary noxa. Case report results: The patient had right pleural parietal and diaphragmatic thickness, with pleural effusion, without lung alterations. He previously underwent left hemicolectomy and liver resection, due to a diverticulitis and a liver histiocytes-rich abscess. Video-assisted thoracoscopy biopsy showed a double population of reactive mesothelial cells and histiocytes.


CONCLUSION
Nodular histiocytic/mesothelial hyperplasia represents a potential pitfall for pathologists. Immunohistochemistry is crucial for the differential diagnosis with some malignancies. We suggest that in our patient, a chronic mesothelium inflammation happened by transdiaphragmatic involvement as a consequence of the liver abscess. Some pathogenetic mechanisms are hypothesized.
['Cabibi|Daniela|D|', 'Lo Iacono|Giorgio|G|', 'Raffaele|Francesco|F|', 'Dioguardi|Salvatore|S|', 'Ingrao|Sabrina|S|', 'Pirrotta|Antonio|A|', 'Fatica|Federica|F|', 'Cajozzo|Massimo|M|']
D001706:Biopsy D004848:Epithelium D006644:Histiocytes D006801:Humans D006965:Hyperplasia D008297:Male D008875:Middle Aged D010994:Pleura D013369:Subphrenic Abscess
mesothelial hyperplasia pleural effusion VATS