Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Barthofer, K.
Spontaneous Pneumothorax: Evaluation of the histology of wedge resections and clinical-pathological correlation – a Pilot study
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2016. pp. 53
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Lindenmann Jörg
- Stacher-Priehse Elvira
- Altmetrics:
- Abstract:
- BACKGROUND: Spontaneous pneumothorax (PTX) may occur with no apparent underlying disease or may be associated with a broad variety of pulmonary disorders. Recently, the presence of fibroblastic foci in the lung tissue of PTX has been described, however, this has not been investigated systematically so far. The aim of our study was to elucidate the frequency of these lesions in pulmonary tissue and to illustrate any clinicopathologic correlations. METHODS: One-hundred and fifty nine consecutive cases of spontaneous pneumothorax, treated with surgery and obtainment of the lung tissue, were enrolled. Cases of PTX were retrieved for a 10-year period between 1994 and 2014. Patients were analysed regarding their personal and histological features with a special focus on fibroblastic foci. Statistical analysis was performed to reveal the commonalities within the study group and also to illustrate the differences between patients with or without fibroblastic foci, patients with no relapse and relapses and patients with a different number of relapses. RESULTS: Out of 159 patients 74% are male, 26% are female. The midpoint for female patients shows an age of 36 years, 1.65m in height, 57kg in weight. The midpoint for male patients shows an age of 30 years, 1.82m in height, 70kg in weight. 67% of all male patients are smokers with an amount of 9 PY, 57% of all female patients are smokers with an amount of 8 PY. 73% of all patients present a history of lung diseases, 16% present a history of systemic diseases. 31% show no relapse, 52% a single relapse, 25% a two-times relapse and 18% three-times or more relapses. 89% of the cases present interstitial inflammation with lymphocytes dominating, 85% present smoker´s macrophages, 79% fibrosis, 73% pleuritis, 58% mesothelial reaction, 55% fibroblastic foci, and 42% bullae. The presence of fibroblastic foci is associated with male sex, younger age, height, a lower BMI and a lower amount of PY compared to the group without fibroblastic foci. Also fibrosis, bullae and lymphocytes are more frequently found in patients with fibroblastic foci. There are no significant associations between fibroblastic lesions and the number of episodes of PTX (relapses/no relapses). CONCLUSION: Patients with pneumothoraces show common personal and histological features. Both, physical predispositions like slim, tall habitus with an underweight BMI, smoking and lung disease as well as changes of the lung tissue including smoker´s macrophages, fibroblastic foci, fibrosis, eosinophilic granulocytes, mesothelial reaction and interstitial inflammation with lymphocytes are seen in tissue of patients with PTX. Young patients who were assumed as healthy without any underlying lung disease may show histopathologic changes of the lung tissue inlcuding a high incidence of fibroblastic foci, fibrosis, bullae as well as interstitial inflammation. Fibroblastic foci are surprisingly often seen in our cohort of patients with PTX. However, it still cannot be determined whether these lesions contribute to the pathogenesis of this disease or whether they are a hallmark of wound healing in affected tissue. Their role in the context of PTX remains elusive. Further studies in this respect are warranted to gain more information.