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(Chest. 1994;106:351-353.)
© 1994 American College of Chest Physicians

Subclinical Surface Alterations of Human Pleura

A Scanning Electron Microscopic Study

Ming-Jen Peng M.D.1; Nai-San Wang M.D., Ph.D.1; Francisco S. Vargas M.D., F.C.C.P.1; and Richard W. Light M.D., F.C.C.P.1

1 From the Departments of Medicine and Pathology, Long Beach Veterans Administration Medical Center and University of California, Irvine, the Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, and the Instituto do Coracao of the Faculty of Medicine of the University of Sao Paulo, Brazil

Pleuritis or pleural effusion frequently develops inpatients with pneumonia or heart failure. Most of these pleural changes regress without intrapleural intervention. The detailed mechanisms of the regression of the pleural changes in humans are not well documented. We studied the parietal pleura of nine patients with lung cancer and two patients with coronary artery disease by scanning electron microscopy (SEM). All patients had neither radiographic nor gross evidence of pleural disease but all had mixed surface alterations by SEM. Focal denudation of mesothelial cells was common. Deeper injuries exposed thick and thin interweaving collagen bundles. Patchy depositions of amorphous or crystalized fibrin covered normal and damaged pleural surfaces, frequently admixed with macrophages, red blood cells, and tissue debris. Reactive mesothelial cells appeared to proliferate over the fibrin. Our findings suggest that subclinical pleural alterations occur often in patients with pulmonary or cardiac diseases and that an intact pleural surface in those patients is restored mainly by the proliferation of reactive mesothelial cells.

Key Words: mesothelial cells • pleura • pleura repair • scanning electron microscopy

Submitted on September 7, 1993
Accepted on December 29, 2007




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