{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T17:01:23Z","timestamp":1773680483776,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To report histologic features of unsuspected diffuse pleural mesothelioma (DPM) in surgical specimens for pneumothorax and demonstrate how ancillary markers support a diagnosis of malignancy in this context. We explored whether pneumothorax may be a clinical manifestation of mesothelioma in situ (MIS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A single-institution database search identified patients who underwent surgical resection for spontaneous pneumothorax (n = 229) and\/or were diagnosed with DPM (n = 88) from 2000 to 2020.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Spontaneous pneumothorax without clinical, radiologic, or intraoperative suspicion of mesothelioma was the initial presentation in 2 (2.3%) of 88 patients diagnosed with DPM. This represented 0.9% (2\/229) of all patients undergoing surgical management of pneumothorax but accounted for a larger proportion of older patients (12.5% older than 70 years). Immunohistochemistry for BAP-1 and\/or MTAP confirmed the diagnosis of DPM in 2 cases. Mesothelioma in situ was identified retrospectively by immunohistochemistry in 1 case of spontaneous pneumothorax from a 77-year-old man who developed invasive DPM 25 months later. No additional cases of MIS were identified in 19 surgical lung resections for spontaneous pneumothorax.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Histologic examination of bleb resections with ancillary testing for cases with ambiguous features is essential for detection of early DPM. It is uncertain whether spontaneous pneumothorax may represent a clinical manifestation of MIS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqad057","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T15:59:25Z","timestamp":1685548765000},"page":"322-330","source":"Crossref","is-referenced-by-count":2,"title":["Clinically Occult Diffuse Pleural Mesothelioma in Patients Presenting With Spontaneous Pneumothorax"],"prefix":"10.1093","volume":"160","author":[{"given":"Daffolyn Rachael","family":"Fels Elliott","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Kansas Medical Center , Kansas City, KS , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4582-0120","authenticated-orcid":false,"given":"Kristine E","family":"Konopka","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan , Ann Arbor, MI , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M","family":"Hrycaj","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan , Ann Arbor, MI , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran H","family":"Lagisetty","sequence":"additional","affiliation":[{"name":"Section of Thoracic Surgery, University of Michigan , Ann Arbor, MI , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey L","family":"Myers","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan , Ann Arbor, MI , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol F","family":"Farver","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic , Cleveland, OH , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5162-9410","authenticated-orcid":false,"given":"Tao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan , Ann Arbor, MI , US"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"2023090111553107300_CIT0001","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.21037\/jtd.2019.03.35","article-title":"Secondary spontaneous pneumothorax in cancer patients","volume":"11","author":"Grosu","year":"2019","journal-title":"J Thorac Dis"},{"key":"2023090111553107300_CIT0002","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1378\/chest.09-2292","article-title":"A comprehensive review of spontaneous pneumothorax complicating 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