The significance of pleural elastica invasion by lung carcinomas.

Invasion of visceral pleura by primary lung carcinomas is an important parameter in staging. The complex histology of visceral pleura requires special elastic stains for proper evaluation, yet only approximately 10% of peripheral lung carcinomas seen in consultation (S.J.U.) are thus assessed. The objective of this study was to examine the prognostic importance of microscopic visceral pleura invasion by lung carcinomas. Retrospective analysis of 23 cases of peripheral T2, N0, M0 carcinomas with microscopic pleural invasion on elastic stains and a matched control group documented a statistically significant (P = 0.0236) difference in survival between squamous cell carcinoma subgroups. This study therefore suggests the need for histologic assessment of peripheral lung carcinomas for invasion of internal pleural elastic lamina.