Pleural invasion - Revision history

Michael: /* See also */

2015-11-15T19:01:26Z

Michael: /* Modified Hammar classification */

2015-10-23T05:29:57Z

Modified Hammar classification

← Older revision		Revision as of 05:29, 23 October 2015
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	Notes:		Notes:
	*† The interface between PL0 and PL1 is the most challenging. Use of an elastic stain is recommend when there is uncertainty.<ref name=pmid23020722/>		*† The interface between PL0 and PL1 is the most challenging. Use of an elastic stain is recommend when there is uncertainty.<ref name=pmid23020722/>
	*‡ The up-staging of small tumours is not completely without controversy; there is data for lung ~~adenocarcinomas~~ less than 2 cm that suggests VPI is not an outcome predictor.<ref name=pmid23807749>{{Cite journal \| last1 = Nitadori \| first1 = J. \| last2 = Colovos \| first2 = C. \| last3 = Kadota \| first3 = K. \| last4 = Sima \| first4 = CS. \| last5 = Sarkaria \| first5 = IS. \| last6 = Rizk \| first6 = NP. \| last7 = Rusch \| first7 = VW. \| last8 = Travis \| first8 = WD. \| last9 = Adusumilli \| first9 = PS. \| title = Visceral pleural invasion does not affect recurrence or overall survival among patients with lung adenocarcinoma ≤ 2 cm: a proposal to reclassify T1 lung adenocarcinoma. \| journal = Chest \| volume = 144 \| issue = 5 \| pages = 1622-31 \| month = Nov \| year = 2013 \| doi = 10.1378/chest.13-0394 \| PMID = 23807749 }}</ref>		*‡ The up-staging of small tumours is not completely without controversy; there is data for [[lung adenocarcinoma]]s less than 2 cm that suggests VPI is not an outcome predictor.<ref name=pmid23807749>{{Cite journal \| last1 = Nitadori \| first1 = J. \| last2 = Colovos \| first2 = C. \| last3 = Kadota \| first3 = K. \| last4 = Sima \| first4 = CS. \| last5 = Sarkaria \| first5 = IS. \| last6 = Rizk \| first6 = NP. \| last7 = Rusch \| first7 = VW. \| last8 = Travis \| first8 = WD. \| last9 = Adusumilli \| first9 = PS. \| title = Visceral pleural invasion does not affect recurrence or overall survival among patients with lung adenocarcinoma ≤ 2 cm: a proposal to reclassify T1 lung adenocarcinoma. \| journal = Chest \| volume = 144 \| issue = 5 \| pages = 1622-31 \| month = Nov \| year = 2013 \| doi = 10.1378/chest.13-0394 \| PMID = 23807749 }}</ref>

	==Gross==		==Gross==

Michael: /* General */

2015-10-23T03:50:50Z

General

← Older revision		Revision as of 03:50, 23 October 2015
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	==General==		==General==
	[[Image: Normal visceral pleura of lung - Miller -- high mag.jpg \| thumb\| right\| ~~Lung~~ visceral pleura. [[Miller stain]]. (WC)]]		[[Image: Normal visceral pleura of lung - Miller -- high mag.jpg \| thumb\| right\| Normal visceral pleura of the lung. [[Miller stain]]. (WC)]]
	The visceral pleura is the pleura that covers the [[lung]]; tumour invasion into it is known as '''visceral pleural invasion''' (abbreviated '''VPI'''). The parietal pleural covers the chest wall.		The visceral pleura is the pleura that covers the [[lung]]; tumour invasion into it is known as '''visceral pleural invasion''' (abbreviated '''VPI'''). The parietal pleural covers the chest wall.

Michael: /* Modified Hammar classification */

2015-10-23T03:38:33Z

Modified Hammar classification

← Older revision		Revision as of 03:38, 23 October 2015
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	!Tumour stage ([[TNM staging]])		!Tumour stage ([[TNM staging]])
	\|-		\|-
	\|PL0		\|PL0 †
	\|tumour confined to lung, not through elastic layer		\|tumour confined to lung, not through elastic layer
	\|T(any)		\|T(any)
	\|-		\|-
	\|PL1		\|PL1 †
	\|tumour beyond (external) elastic layer of the visercal pleura, not at pleural surface		\|tumour beyond (external) elastic layer of the visercal pleura, not at pleural surface
	\|at least T2		\|at least T2 ‡
	\|-		\|-
	\|PL2		\|PL2
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	\|}		\|}

	~~Note~~:		Notes:
	*The interface between PL0 and PL1 is the most challenging. Use of an elastic stain is recommend when there is uncertainty.<ref name=pmid23020722/>		*† The interface between PL0 and PL1 is the most challenging. Use of an elastic stain is recommend when there is uncertainty.<ref name=pmid23020722/>
	*The up-staging of small tumours is not completely without controversy; there is data for lung adenocarcinomas less than 2 cm that suggests VPI is not an outcome predictor.<ref name=pmid23807749>{{Cite journal \| last1 = Nitadori \| first1 = J. \| last2 = Colovos \| first2 = C. \| last3 = Kadota \| first3 = K. \| last4 = Sima \| first4 = CS. \| last5 = Sarkaria \| first5 = IS. \| last6 = Rizk \| first6 = NP. \| last7 = Rusch \| first7 = VW. \| last8 = Travis \| first8 = WD. \| last9 = Adusumilli \| first9 = PS. \| title = Visceral pleural invasion does not affect recurrence or overall survival among patients with lung adenocarcinoma ≤ 2 cm: a proposal to reclassify T1 lung adenocarcinoma. \| journal = Chest \| volume = 144 \| issue = 5 \| pages = 1622-31 \| month = Nov \| year = 2013 \| doi = 10.1378/chest.13-0394 \| PMID = 23807749 }}</ref>		*‡ The up-staging of small tumours is not completely without controversy; there is data for lung adenocarcinomas less than 2 cm that suggests VPI is not an outcome predictor.<ref name=pmid23807749>{{Cite journal \| last1 = Nitadori \| first1 = J. \| last2 = Colovos \| first2 = C. \| last3 = Kadota \| first3 = K. \| last4 = Sima \| first4 = CS. \| last5 = Sarkaria \| first5 = IS. \| last6 = Rizk \| first6 = NP. \| last7 = Rusch \| first7 = VW. \| last8 = Travis \| first8 = WD. \| last9 = Adusumilli \| first9 = PS. \| title = Visceral pleural invasion does not affect recurrence or overall survival among patients with lung adenocarcinoma ≤ 2 cm: a proposal to reclassify T1 lung adenocarcinoma. \| journal = Chest \| volume = 144 \| issue = 5 \| pages = 1622-31 \| month = Nov \| year = 2013 \| doi = 10.1378/chest.13-0394 \| PMID = 23807749 }}</ref>

	==Gross==		==Gross==

Michael: /* See also */

2015-10-23T03:36:29Z

Michael: /* Microscopic */

2015-10-23T03:35:39Z

Microscopic

← Older revision		Revision as of 03:35, 23 October 2015
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	Note:		Note:
	*Tumour trapped within the (external) elastic layer is still PL0.<ref name=pmid23020722/>		*Tumour trapped within the (external) elastic layer is still PL0.<ref name=pmid23020722/>

			===Images===
			<gallery>
			Image: Lung adenocarcinoma visceral pleural invasion -- very low mag.jpg \| Adenocarcinoma - VPI - very low mag.
			Image: Lung adenocarcinoma visceral pleural invasion -- low mag.jpg \| Adenocarcinoma - VPI - low mag.
			Image: Lung adenocarcinoma visceral pleural invasion -- intermed mag.jpg \| Adenocarcinoma - VPI - intermed. mag.
			Image: Lung adenocarcinoma visceral pleural invasion - alt -- intermed mag.jpg \| Adenocarcinoma - VPI - intermed. mag.
			Image: Lung adenocarcinoma visceral pleural invasion -- high mag.jpg \| Adenocarcinoma - VPI - high mag.
			Image: Lung adenocarcinoma visceral pleural invasion -- very high mag.jpg \| Adenocarcinoma - VPI - very high mag.
			</gallery>

	==Stains==		==Stains==

Michael: /* General */

2015-10-23T03:33:31Z

General

← Older revision		Revision as of 03:33, 23 October 2015
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	==General==		==General==
			[[Image: Normal visceral pleura of lung - Miller -- high mag.jpg \| thumb\| right\| Lung visceral pleura. [[Miller stain]]. (WC)]]
	The visceral pleura is the pleura that covers the [[lung]]; tumour invasion into it is known as '''visceral pleural invasion''' (abbreviated '''VPI'''). The parietal pleural covers the chest wall.		The visceral pleura is the pleura that covers the [[lung]]; tumour invasion into it is known as '''visceral pleural invasion''' (abbreviated '''VPI'''). The parietal pleural covers the chest wall.

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	**Irrelevant for staging.		**Irrelevant for staging.

			====Images - normal pleural====
			<gallery>
			Image: Normal visceral pleura of lung - Miller -- intermed mag.jpg \| Lung visceral pleura - intermed. mag.
			Image: Normal visceral pleura of lung - Miller - alt -- intermed mag.jpg \| Lung visceral pleura - high mag.
			</gallery>
	===Modified Hammar classification===		===Modified Hammar classification===
	Pleural invasion can be subgrouped as follows:<ref name=pmid19057261/>		Pleural invasion can be subgrouped as follows:<ref name=pmid19057261/>

Michael: /* Stains */

2015-10-23T03:31:47Z

Stains

← Older revision		Revision as of 03:31, 23 October 2015
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	Image: Lung adenocarcinoma visceral pleural invasion - Miller -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.		Image: Lung adenocarcinoma visceral pleural invasion - Miller -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
	Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.		Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
	~~Image: Lung adenocarcinoma visceral pleural invasion - Miller -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.~~
	~~Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.~~
	Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very high mag.jpg \| Adenocarcinoma - VPI - Miller - very high mag.		Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very high mag.jpg \| Adenocarcinoma - VPI - Miller - very high mag.
	</gallery>		</gallery>

Michael at 03:31, 23 October 2015

2015-10-23T03:31:14Z

← Older revision		Revision as of 03:31, 23 October 2015
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	[[Image:Lung adenocarcinoma visceral pleural invasion -- intermed mag.jpg\|thumb\|right\|Visceral pleural invasion. [[H&E stain]]. (WC)]]		[[Image:Lung adenocarcinoma visceral pleural invasion -- intermed mag.jpg\|thumb\|right\|Visceral pleural invasion. [[H&E stain]]. (WC)]]
	~~[[Image:Lung adenocarcinoma visceral pleural invasion - Miller -- high mag.jpg\|thumb\|right\|Visceral pleural invasion. [[Miller stain]]. (WC)]]~~
	'''Pleural invasion''' is the presence of tumour in the [[pleura]]. Pleural invasion is considered a poor prognosticator in [[lung cancer]],<ref name=pmid19057261>{{Cite journal \| last1 = Travis \| first1 = WD. \| last2 = Brambilla \| first2 = E. \| last3 = Rami-Porta \| first3 = R. \| last4 = Vallières \| first4 = E. \| last5 = Tsuboi \| first5 = M. \| last6 = Rusch \| first6 = V. \| last7 = Goldstraw \| first7 = P. \| title = Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. \| journal = J Thorac Oncol \| volume = 3 \| issue = 12 \| pages = 1384-90 \| month = Dec \| year = 2008 \| doi = 10.1097/JTO.0b013e31818e0d9f \| PMID = 19057261 }}</ref><ref name=pmid15999057>{{Cite journal \| last1 = Shimizu \| first1 = K. \| last2 = Yoshida \| first2 = J. \| last3 = Nagai \| first3 = K. \| last4 = Nishimura \| first4 = M. \| last5 = Ishii \| first5 = G. \| last6 = Morishita \| first6 = Y. \| last7 = Nishiwaki \| first7 = Y. \| title = Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer. \| journal = J Thorac Cardiovasc Surg \| volume = 130 \| issue = 1 \| pages = 160-5 \| month = Jul \| year = 2005 \| doi = 10.1016/j.jtcvs.2004.11.021 \| PMID = 15999057 }}</ref> and important in determining the tumour stage in [[lung cancer staging]].		'''Pleural invasion''' is the presence of tumour in the [[pleura]]. Pleural invasion is considered a poor prognosticator in [[lung cancer]],<ref name=pmid19057261>{{Cite journal \| last1 = Travis \| first1 = WD. \| last2 = Brambilla \| first2 = E. \| last3 = Rami-Porta \| first3 = R. \| last4 = Vallières \| first4 = E. \| last5 = Tsuboi \| first5 = M. \| last6 = Rusch \| first6 = V. \| last7 = Goldstraw \| first7 = P. \| title = Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. \| journal = J Thorac Oncol \| volume = 3 \| issue = 12 \| pages = 1384-90 \| month = Dec \| year = 2008 \| doi = 10.1097/JTO.0b013e31818e0d9f \| PMID = 19057261 }}</ref><ref name=pmid15999057>{{Cite journal \| last1 = Shimizu \| first1 = K. \| last2 = Yoshida \| first2 = J. \| last3 = Nagai \| first3 = K. \| last4 = Nishimura \| first4 = M. \| last5 = Ishii \| first5 = G. \| last6 = Morishita \| first6 = Y. \| last7 = Nishiwaki \| first7 = Y. \| title = Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer. \| journal = J Thorac Cardiovasc Surg \| volume = 130 \| issue = 1 \| pages = 160-5 \| month = Jul \| year = 2005 \| doi = 10.1016/j.jtcvs.2004.11.021 \| PMID = 15999057 }}</ref> and important in determining the tumour stage in [[lung cancer staging]].

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	==Stains==		==Stains==
			[[Image:Lung adenocarcinoma visceral pleural invasion - Miller - alt -- high mag.jpg\|thumb\|right\|Visceral pleural invasion. [[Miller stain]]. (WC)]]
	*Elastic stain (e.g. [[Miller stain\|Miller]], [[Elastic trichrome stain\|elastic trichrome]], [[Verhoeff-van Gieson stain\|Verhoeff-van Gieson]]) - demonstrating tumour superficial to the (external) elastica.		*Elastic stain (e.g. [[Miller stain\|Miller]], [[Elastic trichrome stain\|elastic trichrome]], [[Verhoeff-van Gieson stain\|Verhoeff-van Gieson]]) - demonstrating tumour superficial to the (external) elastica.

			===Images===
			<gallery>
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very low mag.jpg \| Adenocarcinoma - VPI - Miller - very low mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- low mag.jpg \| Adenocarcinoma - VPI - Miller - low mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very high mag.jpg \| Adenocarcinoma - VPI - Miller - very high mag.
			</gallery>

	==See also==		==See also==

Michael at 03:25, 23 October 2015

2015-10-23T03:25:11Z

← Older revision		Revision as of 03:25, 23 October 2015
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			[[Image:Lung adenocarcinoma visceral pleural invasion -- intermed mag.jpg\|thumb\|right\|Visceral pleural invasion. [[H&E stain]]. (WC)]]
			[[Image:Lung adenocarcinoma visceral pleural invasion - Miller -- high mag.jpg\|thumb\|right\|Visceral pleural invasion. [[Miller stain]]. (WC)]]
	'''Pleural invasion''' is the presence of tumour in the [[pleura]]. Pleural invasion is considered a poor prognosticator in [[lung cancer]],<ref name=pmid19057261>{{Cite journal \| last1 = Travis \| first1 = WD. \| last2 = Brambilla \| first2 = E. \| last3 = Rami-Porta \| first3 = R. \| last4 = Vallières \| first4 = E. \| last5 = Tsuboi \| first5 = M. \| last6 = Rusch \| first6 = V. \| last7 = Goldstraw \| first7 = P. \| title = Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. \| journal = J Thorac Oncol \| volume = 3 \| issue = 12 \| pages = 1384-90 \| month = Dec \| year = 2008 \| doi = 10.1097/JTO.0b013e31818e0d9f \| PMID = 19057261 }}</ref><ref name=pmid15999057>{{Cite journal \| last1 = Shimizu \| first1 = K. \| last2 = Yoshida \| first2 = J. \| last3 = Nagai \| first3 = K. \| last4 = Nishimura \| first4 = M. \| last5 = Ishii \| first5 = G. \| last6 = Morishita \| first6 = Y. \| last7 = Nishiwaki \| first7 = Y. \| title = Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer. \| journal = J Thorac Cardiovasc Surg \| volume = 130 \| issue = 1 \| pages = 160-5 \| month = Jul \| year = 2005 \| doi = 10.1016/j.jtcvs.2004.11.021 \| PMID = 15999057 }}</ref> and important in determining the tumour stage in [[lung cancer staging]].		'''Pleural invasion''' is the presence of tumour in the [[pleura]]. Pleural invasion is considered a poor prognosticator in [[lung cancer]],<ref name=pmid19057261>{{Cite journal \| last1 = Travis \| first1 = WD. \| last2 = Brambilla \| first2 = E. \| last3 = Rami-Porta \| first3 = R. \| last4 = Vallières \| first4 = E. \| last5 = Tsuboi \| first5 = M. \| last6 = Rusch \| first6 = V. \| last7 = Goldstraw \| first7 = P. \| title = Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. \| journal = J Thorac Oncol \| volume = 3 \| issue = 12 \| pages = 1384-90 \| month = Dec \| year = 2008 \| doi = 10.1097/JTO.0b013e31818e0d9f \| PMID = 19057261 }}</ref><ref name=pmid15999057>{{Cite journal \| last1 = Shimizu \| first1 = K. \| last2 = Yoshida \| first2 = J. \| last3 = Nagai \| first3 = K. \| last4 = Nishimura \| first4 = M. \| last5 = Ishii \| first5 = G. \| last6 = Morishita \| first6 = Y. \| last7 = Nishiwaki \| first7 = Y. \| title = Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer. \| journal = J Thorac Cardiovasc Surg \| volume = 130 \| issue = 1 \| pages = 160-5 \| month = Jul \| year = 2005 \| doi = 10.1016/j.jtcvs.2004.11.021 \| PMID = 15999057 }}</ref> and important in determining the tumour stage in [[lung cancer staging]].

← Older revision		Revision as of 19:01, 15 November 2015
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	*[[Lung tumours]].		*[[Lung tumours]].
	*[[Lung cancer staging]].		*[[Lung cancer staging]].
			*[[Pleural effusion]].
			*[[Pleura]].

	==References==		==References==

← Older revision		Revision as of 03:36, 23 October 2015
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	==See also==		==See also==
	*[[Lung tumours]].		*[[Lung tumours]].
			*[[Lung cancer staging]].

	==References==		==References==

← Older revision		Revision as of 03:31, 23 October 2015
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	Image: Lung adenocarcinoma visceral pleural invasion - Miller -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.		Image: Lung adenocarcinoma visceral pleural invasion - Miller -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
	Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.		Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
	~~Image: Lung adenocarcinoma visceral pleural invasion - Miller -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.~~
	~~Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.~~
	Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very high mag.jpg \| Adenocarcinoma - VPI - Miller - very high mag.		Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very high mag.jpg \| Adenocarcinoma - VPI - Miller - very high mag.
	</gallery>		</gallery>

← Older revision		Revision as of 03:31, 23 October 2015
Line 1:		Line 1:
	[[Image:Lung adenocarcinoma visceral pleural invasion -- intermed mag.jpg\|thumb\|right\|Visceral pleural invasion. [[H&E stain]]. (WC)]]		[[Image:Lung adenocarcinoma visceral pleural invasion -- intermed mag.jpg\|thumb\|right\|Visceral pleural invasion. [[H&E stain]]. (WC)]]
	~~[[Image:Lung adenocarcinoma visceral pleural invasion - Miller -- high mag.jpg\|thumb\|right\|Visceral pleural invasion. [[Miller stain]]. (WC)]]~~
	'''Pleural invasion''' is the presence of tumour in the [[pleura]]. Pleural invasion is considered a poor prognosticator in [[lung cancer]],<ref name=pmid19057261>{{Cite journal \| last1 = Travis \| first1 = WD. \| last2 = Brambilla \| first2 = E. \| last3 = Rami-Porta \| first3 = R. \| last4 = Vallières \| first4 = E. \| last5 = Tsuboi \| first5 = M. \| last6 = Rusch \| first6 = V. \| last7 = Goldstraw \| first7 = P. \| title = Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. \| journal = J Thorac Oncol \| volume = 3 \| issue = 12 \| pages = 1384-90 \| month = Dec \| year = 2008 \| doi = 10.1097/JTO.0b013e31818e0d9f \| PMID = 19057261 }}</ref><ref name=pmid15999057>{{Cite journal \| last1 = Shimizu \| first1 = K. \| last2 = Yoshida \| first2 = J. \| last3 = Nagai \| first3 = K. \| last4 = Nishimura \| first4 = M. \| last5 = Ishii \| first5 = G. \| last6 = Morishita \| first6 = Y. \| last7 = Nishiwaki \| first7 = Y. \| title = Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer. \| journal = J Thorac Cardiovasc Surg \| volume = 130 \| issue = 1 \| pages = 160-5 \| month = Jul \| year = 2005 \| doi = 10.1016/j.jtcvs.2004.11.021 \| PMID = 15999057 }}</ref> and important in determining the tumour stage in [[lung cancer staging]].		'''Pleural invasion''' is the presence of tumour in the [[pleura]]. Pleural invasion is considered a poor prognosticator in [[lung cancer]],<ref name=pmid19057261>{{Cite journal \| last1 = Travis \| first1 = WD. \| last2 = Brambilla \| first2 = E. \| last3 = Rami-Porta \| first3 = R. \| last4 = Vallières \| first4 = E. \| last5 = Tsuboi \| first5 = M. \| last6 = Rusch \| first6 = V. \| last7 = Goldstraw \| first7 = P. \| title = Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. \| journal = J Thorac Oncol \| volume = 3 \| issue = 12 \| pages = 1384-90 \| month = Dec \| year = 2008 \| doi = 10.1097/JTO.0b013e31818e0d9f \| PMID = 19057261 }}</ref><ref name=pmid15999057>{{Cite journal \| last1 = Shimizu \| first1 = K. \| last2 = Yoshida \| first2 = J. \| last3 = Nagai \| first3 = K. \| last4 = Nishimura \| first4 = M. \| last5 = Ishii \| first5 = G. \| last6 = Morishita \| first6 = Y. \| last7 = Nishiwaki \| first7 = Y. \| title = Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer. \| journal = J Thorac Cardiovasc Surg \| volume = 130 \| issue = 1 \| pages = 160-5 \| month = Jul \| year = 2005 \| doi = 10.1016/j.jtcvs.2004.11.021 \| PMID = 15999057 }}</ref> and important in determining the tumour stage in [[lung cancer staging]].

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	==Stains==		==Stains==
			[[Image:Lung adenocarcinoma visceral pleural invasion - Miller - alt -- high mag.jpg\|thumb\|right\|Visceral pleural invasion. [[Miller stain]]. (WC)]]
	*Elastic stain (e.g. [[Miller stain\|Miller]], [[Elastic trichrome stain\|elastic trichrome]], [[Verhoeff-van Gieson stain\|Verhoeff-van Gieson]]) - demonstrating tumour superficial to the (external) elastica.		*Elastic stain (e.g. [[Miller stain\|Miller]], [[Elastic trichrome stain\|elastic trichrome]], [[Verhoeff-van Gieson stain\|Verhoeff-van Gieson]]) - demonstrating tumour superficial to the (external) elastica.

			===Images===
			<gallery>
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very low mag.jpg \| Adenocarcinoma - VPI - Miller - very low mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- low mag.jpg \| Adenocarcinoma - VPI - Miller - low mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- intermed mag.jpg \| Adenocarcinoma - VPI - Miller - intermed. mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller - alt -- high mag.jpg \| Adenocarcinoma - VPI - Miller - high mag.
			Image: Lung adenocarcinoma visceral pleural invasion - Miller -- very high mag.jpg \| Adenocarcinoma - VPI - Miller - very high mag.
			</gallery>

	==See also==		==See also==