Source: Annual Congress 2002 - Pleural disease
Disease area: Thoracic oncology

Abstract

Diagnostic thoracoscopy under local anesthesia is a useful tool in the workup of exudative pleuritis after (repeated) non-diagnostic thoracocenthesis. The diagnostic sensitivity of thoracoscopy is high, 90-100% in the literature. However, the length of follow-up is many studies is variable or not stated. 'Idiopathic 'or 'non-specific' pleuritis may falsely improve the diagnostic sensitivity, and eventually appear to be a wrong diagnosis after long-term follow-up.
To evaluate the long-term follow-up of non-specific pleuritis, we performed a retrospective study of all patients who underwent thoracoscopy for unexplained exudative pleural effusion in the period 1982-1999.
Results: 709 patients underwent thoracoscopy for pleuritis of indeterminate cause in this period. A diagnosis was obtained in 501 cases (71%). In 318 cases malignant pleuritis was found (45%), and in 183 cases the pleural effusion could be attributed to a specific non-malignant disease (26%). Thoracoscopy revealed no diagnosis other than 'non-specific' pleuritis in 208 cases (29%). After a mean interval of 4.4 months (0-24 months), a malignant pleuritis was found in 31/208 cases (15%).
Conclusion: Out of 208 cases of 'non-specific' pleuritis after thoracoscopy, 31 (15%) appeared to have a malignant pleural disease. A vigilant follow-up is warranted in patients with persisting idiopathic pleuritis.

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Citations should be made in the following way:
S. Ramlal, M. Mravunac, J. P. Janssen (Nijmegen, The Netherlands). Evolution of exudative pleural effusion after non-diagnostic thoracoscopy. Eur Respir J 2002; 20: Suppl. 38, 538

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