Fibrous Tumour of Pleura

Pathophysiology:  A benign fibrous tumour of the pleura comprising mitotic spindle cells and fibrous stroma.  Thought to originate from fibroblasts around the visceral pleura.

Clinical Clues:  Usually without any clinical symptoms and presents with just an abnormal chest x-ray. May be associated with hypertrophic pulmonary osteoarthropathy or hypoglycemia. They rarely undergo malignant transformation.

CXR/CT Findings:  An elliptical pleural based soft tissue mass, generally without calcification.

1.      obtuse angle with pleural surface

2.      can be slow growing

3.      not associated with pleural effusions or adenopathy

Clues:  NOT associated with asbestos exposure or malignant mesothelioma.  These patients are asymptomatic.

“Aunt Sophies”:  on a single image without time course

1.      Pleural lipoma

2.      Peripheral lung mass

3.      Encysted or loculated pleural fluid collection

4.      Pleural metastasis

5.      Pulmonary infarct (with appropriate history)

6.      Extrapleural reaction to underlying infection, osteomyelitis

7.      Neurogenic tumors