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LETTER TO THE EDITOR  
Year : 2014  |  Volume : 24  |  Issue : 4  |  Page : 416
Author's Reply


1 Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
2 Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

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Date of Web Publication3-Nov-2014
 

How to cite this article:
Sureka B, Mittal MK, Mittal A, Sinha M, BhushanThukral B. Author's Reply . Indian J Radiol Imaging 2014;24:416

How to cite this URL:
Sureka B, Mittal MK, Mittal A, Sinha M, BhushanThukral B. Author's Reply . Indian J Radiol Imaging [serial online] 2014 [cited 2020 Feb 17];24:416. Available from: http://www.ijri.org/text.asp?2014/24/4/416/143908
Dear Sir,

We appreciate the interest shown by Vikas et al. in our article. Some of the points highlighted regarding diagnosis of solitary fibrous tumor of pleura (SFTP) have already been discussed in our article. [1]

As SFTP can be sessile or pedunculated, one should not heavily rely on demonstration of change in position by repeat CT scan in prone position. Yes, we do agree that demonstration of change in position clinches the diagnosis. [2]

Round atelectasis is a close differential only when it mimics a pleural-based lesion on chest radiograph. However, CT is diagnostic and no further tests are required.

The causes and associations of pleural effusion have been highlighted in  [Table 4] of our article published in November 2013 issue. [1] We agree that simple pleural fluid aspiration and gross appearance of the pleural fluid may substantially narrow the radiological differential diagnosis of pleural tumors. To add further, the ADA isoenzyme that increases in tuberculous pleural effusions is ADA-2 and in nontuberculous effusions, it is ADA-1. However, even the combined use of ADA, ADA-2, and the 2'-deoxyadenosine deaminase/ADA ratio does not fully distinguish between tuberculous and nontuberculous effusions sometimes. Therefore, ADA analysis is more important in the study of pleural effusions in patients aged under 35 years. [3]

There are a number of causes of hemothorax. The most common are traumatic and iatrogenic causes. Apart from malignant causes, even necrotizing infections, blood dyscrasias, vascular causes, etc., can present as hemothorax. [4]

To conclude, only biopsy or fine needle aspiration cytology (FNAC) is definitive.



 
   References Top

1.
Sureka B, Thukral BB, Mittal MK, Mittal A, Sinha M. Radiological review of pleural tumors. Indian J Radiol Imaging 2013;23:313-20.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Robinson LA.Solitary fibrous tumor of the pleura.Cancer Control 2006;13:264-9.  Back to cited text no. 2
[PUBMED]    
3.
Valdés L, San José E, Alvarez D, Valle JM. Adenosine deaminase (ADA) isoenzyme analysis in pleural effusions: Diagnostic role, and relevance to the origin of increased ADA in tuberculous pleurisy.EurRespir J 1996;9:747-51.  Back to cited text no. 3
    
4.
VillenaGarrido V, Ferrer Sancho J, Hernández Blasco L, de Pablo Gafas A, Pérez Rodríguez E, RodríguezPanadero F, et al.;Area de Tecnicas y Trasplantes. SEPAR.Diagnosis and treatment of pleural effusion. Arch Bronconeumol 2006;42:349-72.  Back to cited text no. 4
    

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Correspondence Address:
Binit Sureka
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


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