Table 1. Numbers of Cancerous Pleurisy Cases According to Primary Site Table 2. Histological Type of Lung Carcinoma with Cancerous Pleurisy at Autopsy

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1 Clinicopathological Studies on Cancerous Pleurisy, with Emphasis on Extra-Pulmonary Malignancy

2 Table 1. Numbers of Cancerous Pleurisy Cases According to Primary Site Table 2. Histological Type of Lung Carcinoma with Cancerous Pleurisy at Autopsy

3 Table 3. Extrapulmonary Malignancy with Cancerous Pleurisy Table 4. Primary Site of Cancerous Pleurisy Present from the Onset of Disease Table 5. Sex Distribution of Cancerous Pleurisy

4 Table 6. Age of Cancerous Pleurisy Cases Table 7. Side of Radiological Pleural Effusion (During the Whole Course) Table 8. Sputum Cytology of Lung Cancer with Cancerous Pleurisy Table 9. Mean Survival Time

5 Table 10. The Relation between the Pattern of Lung Metastasis and Cancerous Pleurisy

6 Table 11. The Relations between Lung Metastasis and Cancerous Pleurisy Ovarial ca. Renal ca. Ovarial ca. Gastric ca. liver metastasis Gastric ca. para aortic intrathoracic

7 Table 12. The Relation between Hilar Lymph Node Metastasis and Cancerous Pleurisy Table 13. Relationship between Distant Organ Metastasis and Cancerous Pleurisy in Lung Cancer

8

9 Cancer, 38, , ) Izbicki, R. Weyhing, B. T., Bakev, L, etal Cancer, 36, 1511 `1518, ) Maber, G. G., Berger, H. W., Amer Rev Resp Dis, 105, 458 `460, ) Latour, A. Shulman, H. S Radiology, 121, 43 `48, ) Harley, H. R. S : Thorax, 31, 485 `486, ) Wanebo, H. J., Martini, N., Melamed M. R. etal:

10 Clinicopathological Studies on Cancerous Pleurisy, with Emphasis on Extra-Pulmonary Malignancy Koichi Yoshikawa*, Kazuro Iwai, Masako Wada, Hironobu Sugita and Yoshinori Kawa ba to Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo. Primary tumor sites and the type of development of pleurisy were studied in 91 autopsied cases of cancerous pleurisy, of which 62 were primary lung cancer and 21 cases were of extrathoracic origin. In lung cancer, adenocarcinoma showed the highest rate of cancerous pleurisy with 80.9%, squamous cell carcinoma 35.5% and small cell carcinoma 55.5%. Tumors from various extrathoracic organs may also cause cancerous pleurisy such as tumors of the stomach, liver, kidney, ovarium, mammary gland and bone marrow. Cancerous pleurisy with unknown primary tumor site during the clinical course were found at autopsy to be lung cancer arising in the subpleural area in 4 cases, and intraabdominal cancer in 6 cases. Carcinomatosis lymphangiosis in the lung was found significantly more frequently in cases with cancerous pleurisy than those without pleurisy and nodular dissemination of the tumor in the lung, probably as a result of hematologic metastasis, was also more frequent in cases with pleurisy than those without, and it was the same in cases of hematologic metastasis to distant organs, too. In 2 gastric, 2 ovarian and 1 renal carcinoma, direct tumor invasion through the diaphragmatic interstitial tissue from the peritoneal to the pleural side were detected microscopically. The clinical picture of cancerous pleurisies originating from the lung and those from extrapulmonary organs did not differ except for the fact that bilateral effusion appeared more early and often in the latter. The mean survival time from the onset/discovery of the disease to death was estimated to be 12.3 months in cases of cancerous pleurisy in primary lung cancer, while it was 11.0 months in cases of extrapulmonary cancers.

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