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European Journal of Cardio-Thoracic Surgery, Vol 11, 328-332, Copyright © 1997 by European Association for Cardio-thoracic Surgery

ARTICLES

The clinical and pathologic manifestations of iatrogenically produced mesothelium-rich fragments of operative debris

VM Walley, HJ Peters, JP Veinot, RW Courtice and SL Venance
Department of Laboratory Medicine, University of Ottawa Heart Institute, Ontario, Canada.

OBJECTIVE: This report describes the clinical manifestations that may be associated with the amalgams of mesothelium and other debris which can be created iatrogenically when body cavities are opened or otherwise physically disturbed. METHODS: One autopsy and four surgical pathology cases are reviewed. Three of the studied patients had had recent cardiac surgery, one a laparotomy, and the fifth a thoracotomy. RESULTS: The series of five patients in this report demonstrates a wide range of manifestations when these tissue and debris amalgams are created. If the fragments gain an ingress to the vasculature, they may embolize and cause infarcts; if the origin of the amalgams is unappreciated, they may be confused with neoplasms; in other circumstances, the amalgams may represent incidental accompaniments of surgical specimens. CONCLUSION: Pathologists and clinicians should be aware of this recently described entity; only in the last couple of years has its pathogenesis been recognized. This report reviews an, until now, undescribed broad spectrum of clinical manifestations of these amalgams of iatrogenically created mesothelial and other operative debris.

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