General Thoracic and Cardiovascular Surgery

, Volume 65, Issue 11, pp 667–669 | Cite as

Mesothelioid reaction following talc pleurodesis: a case report

  • Tatyana Faynberg
  • Neha Patel
  • Amrit P. Nayar
  • Alan J. Shienbaum
Case Report

Abstract

Introduction

Talc pleurodesis is a well-established procedure performed to obliterate the pleural space to prevent recurrent pleural effusion and/or recurrent pneumothorax. Pleurodesis is commonly accomplished by draining the pleural fluid, if present, followed by either a mechanical procedure, such as abrasion, pleurectomy, or instillation of a chemical irritant into the pleural space, which results in inflammation and fibrosis which obliterates the pleural space. The reported complications of talc pleurodesis are hypoxemia, hypotension, tachycardia, dyspnea, chest pain, and fever.

Case presentation

Herein, we present a case of a 43-year-old female patient who developed an intense mesothelioid reaction which occurred 7 years following talc pleurodesis.

Conclusion

This case represents a unique mesothelioid reaction which became manifested several years after recurrent talc pleurodesis. Such a mesothelioid reaction can clinically and radiographically mimic malignant mesothelioma. We conclude that Talc pleurodesis played a causative role in this patient developing an intense mesothelioid reaction. A mesothelioid reaction should be included in the differential diagnosis in patients with pleural thickening/pleural plaque formation who have previously been treated with talc pleurodesis.

Keywords

Talc Pleurodesis Mesothelioid reaction Mesothelioma 

Notes

Compliance with ethical standards

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Conflict of interest

None.

Data availability

Data sharing not applicable to this article as no data sets were generated or analyzed during the current study.

Funding sources

No funding sources were obtained for this case report.

References

  1. 1.
    Davies HE, Lee YC. Management of malignant pleural effusions: questions that need answers. Curr Opin Pulm Med. 2013;19:374.CrossRefPubMedGoogle Scholar
  2. 2.
    Walker-Renard PB, Vaughan LM, Sahn SA. Chemical pleurodesis for malignant pleural effusions. Ann Intern Med. 1994;120:56–64.CrossRefPubMedGoogle Scholar
  3. 3.
    Kennedy L, Sahn SA. Talc pleurodesis for the treatment of pneumothorax and pleural effusion. Chest. 1994;106:1215–22.CrossRefPubMedGoogle Scholar
  4. 4.
    Rinaldo JE, Owens GR, Rogers RM. Adult respiratory distress syndrome following intrapleural instillation of talc. J Thorac Cardiovasc Surg. 1983;85:523–6.PubMedGoogle Scholar
  5. 5.
    Sahn SA. Talc should be used for pleurodesis. Am J Respir Crit Care Med. 2000;162(6)2023–2024.CrossRefPubMedGoogle Scholar
  6. 6.
    Maskell NA, Lee YC, Gleeson FV, et al. Randomized trials describing lung inflation after pleurodesis with talc of varying particle size. Am J Respir Crit Care Med. 2004;170:377.CrossRefPubMedGoogle Scholar
  7. 7.
    Rossi VF, Vargas FS, Marchi E, et al. Acute inflammatory response secondary to intrapleural administration of two types of talc. Eur Respir J. 2010;35:396.CrossRefPubMedGoogle Scholar
  8. 8.
    Antopol W. Lycopodium granuloma. Arch Pathol. 1933;16:326.Google Scholar
  9. 9.
    Genofre EH, Marchi E, Vargas FS. Inflammation and clinical repercussions of pleurodesis induced by intrapleural talc administration. Clinics. 2007;62:627.CrossRefPubMedGoogle Scholar
  10. 10.
    Noppen M, De Keukeleire T. Pneumothorax. Respiration. 2008;76:121.CrossRefPubMedGoogle Scholar
  11. 11.
    Middleton EA, Daniel JC, Know KS, Williams K. PET positive pleural plaques decades after pleurodesis: mesolthelioma? Southwest J Pulm Crit Care. 2011;2:9–16.Google Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2017

Authors and Affiliations

  • Tatyana Faynberg
    • 1
  • Neha Patel
    • 1
  • Amrit P. Nayar
    • 2
  • Alan J. Shienbaum
    • 3
    • 4
  1. 1.Department of SurgeryRowan University School of Osteopathic MedicineStratfordUSA
  2. 2.Department of SurgeryKennedy University HospitalCherry HillUSA
  3. 3.Department of PathologyRowan University School of Osteopathic MedicineStratfordUSA
  4. 4.Department of PathologyKennedy University HospitalCherry HillUSA

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