title: Histopathology of removed indwelling pleural catheters from patients with malignant pleural diseases.
abstract: OBJECTIVE
  Indwelling pleural catheters (IPC), used for management of malignant pleural effusions, are often left in situ for a long duration. This study reports for the first time the histological findings of IPCs removed from patients with underlying pleural malignancy.
  
  
  METHODS
  Forty-one IPCs (in situ for median 126 days, interquartile range 43-226) that were removed over a 54-month period from a single centre were examined.
  
  
  RESULTS
  Mesothelioma (n = 18) was the predominant underlying malignancy followed by breast, tubo-ovarian and lung carcinomas. The catheter tubing was fully intact macroscopically in all IPCs. There was no evidence of direct tumour invasion or cancer cell growth on the catheter surfaces in none of the 29 IPCs that were histologically examined. Malignant cells were seen within organizing fibrinous tissues in the lumen of 11 IPCs (27%). A foreign body giant cell reaction was present at the cuff site in all the 29 IPC in which the subcutaneous cuff was examined. Acute (n = 10) and/or chronic inflammatory changes were seen in the luminal contents in all 41 IPCs.
  
  
  CONCLUSIONS
  Our study provides reassuring evidence that the IPC material does not support direct tumour growth or invasion even in the setting of high mesothelioma prevalence. See Editorial, page 787.
authors.affiliation: Respiratory Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Tobin
authors.affiliation: Respiratory Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.|University of Western Australia & Institute for Respiratory Research, Perth, Western Australia, 6009, Australia.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Department of Anatomical Pathology, Queen Elizabeth II Medical Centre, Perth, Western Australia, 6009, Australia.
authors.forename: Siaw Ming
authors.initials: SM
authors.lastname: Chai
authors.affiliation: Department of Anatomical Pathology, Queen Elizabeth II Medical Centre, Perth, Western Australia, 6009, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Segal
authors.affiliation: Respiratory Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.|University of Western Australia & Institute for Respiratory Research, Perth, Western Australia, 6009, Australia.
authors.forename: Y C Gary
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling; D020878:Device Removal / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D008654:Mesothelioma / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D035422:Pleural Cavity / Q000473:pathology*; D016066:Pleural Effusion, Malignant / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: cytology; histology; mesothelioma; pleural disease