Outcome of patients with nonspecific pleuritis/fibrosis on thoracoscopic pleural biopsies

Davies, Helen; Nicholson, Jennie E.; Rahman, Najib M.; Wilkinson, Emily M.; Davies, Robert J. O.; Lee, Gary

doi:10.1016/j.ejcts.2010.01.057

Cited by 109 publications

(112 citation statements)

References 28 publications

(27 reference statements)

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“…A 9% to 50% of patients undergoing medical thoracoscopy due to pleural effusion were diagnosed with nonspecific pleuritis (16,17). Two pathways are suggested in the management of these patients; "wait and see" or "decide based on the patient. "…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural Effusion

Özgül¹,

Çetınkaya²,

Tanrıverdi³

et al. 2017

Eurasian J Pulmonol

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Objective: Medical thoracoscopy is a minimally invasive procedure that is performed by experienced pulmonologists under local anesthesia and conscious intravenous sedation. It allows direct observation and evaluation of the pleural space. Our aim is to evaluate the diagnostic efficacy and safety of this procedure while presenting our results of medical thoracoscopy performed by rigid thoracoscopy in our clinic. Methods:Thirty-seven patients who had gone thorough medical thoracoscopy between March 2011 and August 2014 were evaluated retrospectively.Results: Of these 37 patients, 26 were male and the average age was 50.94±15.38 years. Fourteen patients had right-sided pleural effusion, whereas 23 had left-sided pleural effusion. Closed pleural biopsy was performed previously in 16 patients with no diagnostic results. In 36 patients (97.3%), a specific diagnosis was achieved. One patient, diagnosed as lymphocytic pleuritis by medical thoracoscopy, underwent decortication and the pathology was consistent with biphasic malignant pleural mesothelioma. Another patient, diagnosed as chronic nonspecific pleuritis with medical thoracoscopy, underwent decortication and the diagnosis was fibrinous pleuritis characterized by extensive fibrosis. Three patients had expansion defects during the post-operative period. Hemothorax occurred in one patient that died of respiratory failure on day 34 of hospitalization. The median length of stay in the hospital after the procedure was 5 days (1-34). Conclusion:Medical thoracoscopy is a secure procedure with high diagnostic value in the management of exudative pleural effusion.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural Effusion

Özgül¹,

Çetınkaya²,

Tanrıverdi³

et al. 2017

Eurasian J Pulmonol

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“…When cytology in conjuncture with immunohistochemistry does not provide a definitive diagnosis, more invasive procedures are indicated. While pleural biopsy yields a high sensitivity (Maskell et al, 2003;Casal et al, 2009), the rate of false negative is between 5-15% and the risk of complications associated with thoracoscopy are non-negligible (Davies et al, 2010). Therefore the search for novel indices is important in order to make up for the limitations of pleural cytology and immunohistochemistry, and to obviate the need for invasive procedures.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Interleukin 21 and Carcinoembryonic Antigen Levels in Malignant Pleural Effusions

Bunjhoo¹,

Wang²,

Chen³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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The aim of this study was to evaluate the diagnostic value of interleukin 21(IL-21) and carcinoembryonic antigen (CEA) in tuberculous pleural effusions (TPEs) and malignant pleural effusions (MPEs). Pleural effusion samples from 103 patients were classified on the basis of diagnosis as TPE (n=51) and MPE (n=52). The concentration of IL-21 was determined by ELISA. Lactate dehydrogenase (LDH), adenosine dehydrogenase (ADA) and CEA levels were also determined in all patients. A significant difference was observed in the levels of ADA and CEA (P<0.01), but not in the levels of LDH (P>0.05) between TPE and MPE. The concentration of IL-21 in MPE was significantly higher compared to TPE (P<0.01). With a threshold value of 4.32 pg/ml, IL-21 had a sensitivity of 76.9% (40/52) and a specificity of 80.4% (41/51). Combined detection of IL-21 and CEA had a sensitivity of 69.2% (36/52) and a specificity of 92.2% (47/51). These two markers can contribute to the differential diagnosis of MPEs.

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“…However, even after diagnostic MT, a clear diagnosis was not established in 62 (7.4%) patients, and the pleuritis was subsequently defined as "nonspecific" (26). Undoubtedly, the follow-up of nonspecific pleuritis is an important clinical problem, because several studies showed among these patients, 8.3-18% were eventually diagnosed with MPE, usually malignant pleural mesothelioma, during longterm follow-up (50,51). However, on which there was only one retrospective report has been published in China (28).…”

Section: Future Perspectives Of Medical Thoracoscopymentioning

confidence: 99%

Medical thoracoscopy in China—the present status and the future

et al. 2017

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Outcome of patients with nonspecific pleuritis/fibrosis on thoracoscopic pleural biopsies

Abstract: Thoracoscopic pleural biopsy is valuable in the diagnosis of pleural malignancies. Patients with 'nonspecific pleuritis/fibrosis' require follow-up as a malignant diagnosis (especially mesothelioma) may eventually be established in approximately 12% of cases.

Cited by 109 publications

References 28 publications

Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural Effusion

Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural Effusion

Diagnostic Value of Interleukin 21 and Carcinoembryonic Antigen Levels in Malignant Pleural Effusions

Medical thoracoscopy in China—the present status and the future

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