RT Journal Article
SR Electronic
T1 Significance and long-term outcome of nonspecific pleuritis after medical thoracoscopy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3363
VO 40
IS Suppl 56
A1 Xanthi Tsiafaki
A1 Maria Chorti
A1 Niki Maounis
A1 Maria Kokolaki
A1 Constantinos Mantzouranis
A1 Vasiliki Filaditaki
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P3363.abstract
AB Introduction: A specific diagnosis of an exudative pleural effusion (EPE) often poses a clinical challenge for the pulmonary physician. Although medical thoracoscopy (MTH) remains the gold standard technique in the work up of patients with EPE a definite histological diagnosis will not be established in a significant number of the cases and will therefore be, characterized as non specific pleuritis (NSP). Objective: To study the outcome of patients with NSP in a group of patients with long term follow up. Method: A retrospective analysis was performed on 110 patients who underwent thoracoscopy for EPE, over a 7 year period, at our Institution. In 47(42,7%) cases, that were histologically diagnosed as NSP, long-term follow up (a minimum of 24 months) was available. MTH was performed by a respiratory physician, experienced in the procedure, under local anesthesia and IV/IM sedation.Results: A definite histological diagnosis was established in 63 patients. In the remaining 47 (42.7%), 35 men and 12 women with mean age of 64.5 years, the diagnosis of NSP was rendered. Four of the latter (8.5%) were subsequently diagnosed with malignancy after an interval of 3-5 months (2 mesotheliomas, 2 adenocarcinoma). A probable cause was established on clinical grounds in 13(27.6%) cases. Finally, in 30 (63.8%) patients, the underlying etiology for NSP was not discovered and was therefore, described as “idiopathic pleuritis”.Conclusions: In our series 3.6% proved to be false negative, after a mean follow up of 4 months. Furthermore, in 27.3% of our undiagnosed EPE cases, a definite diagnosis could not be determined and was characterized as “idiopathic pleuritis”.