Scientific Letter
Pleural Effusion Caused by a Capillary Hemangioma in the Pleural Cavity
Derrame pleural secundario a un hemangioma capilar de localización pleural
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=> "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "538" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Derrame pleural eosinofílico secundario a síndrome hipereosinofílico idiopático" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 570 "Ancho" => 953 "Tamanyo" => 66698 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography showing bilateral pleural effusion with lack of pulmonary involvement.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Lima Álvarez, Nicolás Peña Griñán, Isabel Simón Pilo" "autores" => array:3 [ 0 => array:2 [ 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[ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2500 "Ancho" => 2215 "Tamanyo" => 483553 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">PET/CT showed FDG uptake in multiple lung nodules (A), but not in PA aneurysm (B). 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She was diagnosed with left pleural effusion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). We performed thoracocentesis to evacuate fluid for symptomatic relief. The fluid obtained was opalescent, consistent with sparsely cellular exudate, with normal adenosine deanimase (ADA) values, and negative cytology and microbiology. The usual causes of exudate were ruled out by imaging studies (echocardiogram, computed axial tomography) and clinical laboratory tests (complete blood count, kidney and liver function, and autoantibodies [ANAS, ANCAS and lupus anticoagulant] negative) and no diagnosis was reached. Single port video-assisted thoracoscopy (VATS) was then performed, showing, after evacuation of the effusion, a pleural tumor measuring 5×5<span class="elsevierStyleHsp" style=""></span>cm in the posterior sulcus. An anterolateral thoractomy was necessary to resect the lesion from the pleura with 2<span class="elsevierStyleHsp" style=""></span>cm margins of healthy pleura around the pedicle, after confirming that it did not infiltrate any other structure. Immunohistochemical studies were performed, showing positivity for CD31 and factor 8, and a Ki67 proliferation index <5%, yielding a definitive diagnosis on pathology of pleural capillary hemangioma.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Hemangiomas are neoplasms characterized by vascular proliferation, and are sometimes confounded with other diseases such as arteriovenous vascular malformations.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> They are classified as cavernous or capillary, depending on the diameter of the vascular channels comprising the tumor.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The pathogenesis of hemangiomas is unknown. They can be found in any part of the body, although they most typically appear on the skin and in the liver, and are very rarely found in sites such as the chest. It is even more rare to find them in the ribs<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> or the mediastinum, where they occur at incidence of 0.5% of all masses in these sites.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> To our knowledge, only 2 cases of pleural hemangioma have been described to date. One of these was accompanied by bloody pleural effusion,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> as might be expected, and the other presented with non-bloody effusion, but was cavernous<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> rather than capillary as in our case. Most hemangiomas are observed in young adults, before the age of 35 years. They are usually found by chance or after spontaneous rupture causing bleeding or hemorrhagic pleural effusion. Symptoms are generally non-specific, and include cough, chest pain and dyspnea,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> as seen in our patient. Treatment must be individualized, depending on the site and depth of the infiltration.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> The most usual approaches are surgical resection (as in our patient), cryotherapy, embolization or vascular ligation. Corticosteroids and cyclophosphamide have also been used. It is unusual for hemangiomas to relapse, and our patient is no exception: she has not had any recurrence of pleural effusion in the 5 months since surgery.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion, this is a case of capillary hemangioma located in the pleura, an extremely rare location, accompanied by non-hemorrhagic pleural effusion, an unexpected presentation in this type of tumor.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Yoldi LAS, Vigil LV, Solis RA. Derrame pleural secundario a un hemangioma capilar de localización pleural. Arch Bronconeumol. 2016;52:537.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 676 "Ancho" => 949 "Tamanyo" => 75487 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT slice showing pleural hemangioma.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hemorrhagic pleural effusion due to pleural hemangioma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Nanaware" 1 => "D. Gothi" 2 => "J.M. 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Tamayo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Chest" "fecha" => "2014" "volumen" => "146" "paginaInicial" => "475A" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Acknowledgement" "texto" => "<p id="par0025" class="elsevierStylePara elsevierViewall">Our thanks to Dr Luis Molinos Martín for his help in writing this report.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005200000010/v2_201609300109/S1579212916301811/v2_201609300109/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005200000010/v2_201609300109/S1579212916301811/v2_201609300109/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916301811?idApp=UINPBA00003Z" ]
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| 2020 December | 58 | 23 | 81 |
| 2020 November | 34 | 16 | 50 |
| 2020 October | 44 | 15 | 59 |
| 2020 September | 24 | 9 | 33 |
| 2020 August | 34 | 11 | 45 |
| 2020 July | 34 | 22 | 56 |
| 2020 June | 24 | 12 | 36 |
| 2020 May | 52 | 25 | 77 |
| 2020 April | 41 | 26 | 67 |
| 2020 March | 76 | 14 | 90 |
| 2020 February | 41 | 25 | 66 |
| 2020 January | 31 | 25 | 56 |
| 2019 December | 51 | 23 | 74 |
| 2019 November | 24 | 24 | 48 |
| 2019 October | 35 | 13 | 48 |
| 2019 September | 30 | 11 | 41 |
| 2019 August | 36 | 18 | 54 |
| 2019 July | 27 | 18 | 45 |
| 2019 June | 22 | 8 | 30 |
| 2019 May | 34 | 17 | 51 |
| 2019 April | 69 | 9 | 78 |
| 2019 March | 48 | 24 | 72 |
| 2019 February | 25 | 21 | 46 |
| 2019 January | 250 | 22 | 272 |
| 2018 December | 43 | 17 | 60 |
| 2018 November | 70 | 23 | 93 |
| 2018 October | 120 | 27 | 147 |
| 2018 September | 26 | 13 | 39 |
| 2018 May | 12 | 0 | 12 |
| 2018 April | 35 | 7 | 42 |
| 2018 March | 16 | 2 | 18 |
| 2018 February | 22 | 9 | 31 |
| 2018 January | 18 | 8 | 26 |
| 2017 December | 37 | 6 | 43 |
| 2017 November | 19 | 6 | 25 |
| 2017 October | 26 | 2 | 28 |
| 2017 September | 25 | 6 | 31 |
| 2017 August | 20 | 28 | 48 |
| 2017 July | 30 | 7 | 37 |
| 2017 June | 32 | 16 | 48 |
| 2017 May | 36 | 12 | 48 |
| 2017 April | 29 | 11 | 40 |
| 2017 March | 15 | 5 | 20 |
| 2017 February | 13 | 16 | 29 |
| 2017 January | 16 | 7 | 23 |
Show all
