PT  - JOURNAL ARTICLE
AU  - Philippos Emmanouil
AU  - Rodoula Tringidou
AU  - Dimitris Chiotis
AU  - Magda Stratiki
AU  - Konstantina Kontogianni
AU  - Nikolaos Koufos
AU  - Sofianna Gennimata
AU  - Spyros Zakynthinos
AU  - Manos Alchanatis
AU  - Gregoris Stratakos
TI  - Classification of findings during medical thoracoscopy: Do they correlate with pathology?
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p3702
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p3702.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p3702.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Medical thoracoscopy although not always conclusive, has been established as the last step in the diagnostic approach of chronic pleurisy. We aimed to assess its diagnostic value and classify endoscopic findings in correlation with histology diagnosis.During the last 5 years, 69 patients (55 males) aged 66±14 (mean±st.dev) underwent medical thoracoscopy in our unit for an undiagnosed exudative pleural effusion following extensive workup. Pleural biopsy revealed malignant pleural mesothelioma (MPM) of various subtypes in 16 (23.2%), non small cell lung cancer (NSCLC) in 9 (13%), extrathoracic malignancy in 3, pleural tuberculosis in 3, paramalignant effusion in 2, angiosarcoma in 2 and Non-Hodgkin lymphoma in 1 patient. In 33 cases (47.8%) biopsy revealed chronic inflammation or “non specific pleurisy”.Endoscopic findings were classified as: pleural thickening, bulging, nodules, adhesions, diffuse infiltration, pleural masses, plaques, hemorrhagic appearance, visceral pleura invasion, pulmonary atelectasis. No significant correlations were found between endoscopic and pathology findings. However, parietal pleural mass had a trend of positive correlation with NSCLC (kappa=0.415, p=0.001) and a trend of inverse correlation with non specific pleurisy (kappa -0.35, p=0.001).Medical thoracoscopy enabled specific diagnoses in more than 50% of prior undiagnosed cases in which all other means had been exhausted. High incidence of MPM in our patients is worth noting. The rest (47.8%) of the cases with non specific findings are continuously under follow up for a possible relapse or change in diagnosis. Endoscopic findings cannot predict final histology which remains the cornerstone of diagnosis.