Pleural metastasis

Introduction The pleural metastasis is mainly from the lungs, followed by the mammary gland, and other common primary sites include the stomach, ovaries, and pancreas. Cancer causes pleural capillary pressure, colloid osmotic pressure, capillary permeability and intrathoracic pressure changes, resulting in pleural effusion - malignant pleural effusion. Malignant pleural effusion, also known as cancerous pleurisy, is a pleural effusion caused by cancer pleural metastasis and pleural cancer itself. Malignant pleural effusion is a common complication of advanced cancer. Once a pleural effusion occurs in a cancer patient, it means that the lesion has spread locally or in the body.

Cause

Causes of pleural metastasis

Pleural metastasis: more common in undifferentiated cancer and adenocarcinoma, less squamous cell carcinoma, as a result of direct invasion or planting of lung cancer.

an examination

Related inspection

Pleural effusion examination pleural effusion chest radiograph chest CT examination chest B-ultrasound

1. Puncture fluid cytology examination.

2, the clinical manifestations of pleural fluid growth is extremely fast, and increased after 2 to 3 days after pumping. Cancer cells can often be found in bloody pleural fluids. Non-blood pleural fluid can not exclude cancer, probably due to less pleural cancer. When conventional pleural cytology and biochemical tests cannot be diagnosed, a pleural biopsy can be used to obtain a histological diagnosis.

Differential diagnosis

Differential diagnosis of pleural metastasis:

Dyspnea is the most common symptom.

1. Pericardial metastasis: refers to the result of metastasis of other parts of the malignant tumor to the pericardium. Pericardial metastases are one of the systemic manifestations of malignant tumors. Pericardial metastases mainly cause acute exudative pericarditis, but are usually asymptomatic. Most were found by chance only during autopsy. However, it is one of the common causes of acute pericarditis in developed countries. In some patients with undiagnosed malignant tumors, leukemia, etc., tamponade may be the earliest manifestation.

2, lung metastasis: generally refers to the deterioration of malignant tumors, transferred to the lungs. The lung is the only place for systemic blood flow, and its abundant capillary bed is a high-efficiency filter, which is a good site for the metastasis of various malignant tumors. 20 to 54% of people who die of malignant tumors have lung metastasis, and 15% of the lungs are the only metastatic site. The occurrence of lung metastases is generally thought to be that the tumor cells stay in the bifurcation of the small arteries or capillaries of the lungs, adhere to the endothelium of the capillaries to form a clot, and pass through the wall of the tube into the connective tissue outside the blood vessels, and then the cells Hyperplasia, becoming a small tumor, forming metastatic tumors.

3. Heart metastasis: refers to the transfer of systemic malignant tumors to the heart through various routes. Here, a tumor is formed and called a cardiac metastasis, which was first reported by Heketoen in 1893. Compared with liver, lung or brain, tumors have less probability of metastasis to the heart, and clinical manifestations are often inconspicuous, but their significance is related to their ability to resemble more common heart diseases and sometimes fatal due to cardiac metastasis.

4, lymphatic metastasis: is the most common form of metastasis of cancer, refers to the invasion of the tumor cells through the lymphatic wall, after the fall off with the lymph fluid was brought to the lymph node of the confluence, and the same tumor as the center. Lymph node metastasis usually begins with the first set of lymph nodes closest to the tumor, and then to the distant distance. When the tumor cells infiltrate and grow at each station, they also spread to adjacent lymph nodes in the group. However, there are exceptions. In some patients, it is also feasible to bypass the lymph nodes in the pathway to directly transfer to distant lymph nodes. The mode of clinical transfer is called a jump transfer. These features increase the complexity of tumor metastasis, resulting in clinical lymph node metastasis that is difficult to find the primary lesion.

5, bone metastasis: is the transfer of some primary disease by blood. Breast cancer is the cancer most prone to bone metastasis. Breast cancer is the most common malignant tumor in the female breast, and it is also one of the most common malignant tumors in women. Cancer patients may have bone metastases in cancer when they have symptoms of bone pain.

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