TY - JOUR T1 - Rapid on-site evaluation of medical thoracoscopic biopsy specimens for the diagnosis of pleural disease JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P492 AU - Ilias Porfyridis AU - Frangiskos Frangopoulos AU - Georgios Georgiadis AU - Alexis Papadopoulos AU - Michalis Michael AU - Paris Vogazianos AU - Andreas Georgiou Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P492.abstract N2 - Introduction: Medical thoracoscopy (MT) is a useful method for the management of pleural disease. Rapid on-site evaluation (ROSE) of transbronchial needle aspirates improves the diagnostic yield of bronchoscopy.Aim: To evaluate the diagnostic value of ROSE of MT biopsy specimens.Methods: Patients with exudative pleural effusions, without specific diagnosis after routine investigation, further investigated with MT, were enrolled in the study. MT was performed under local anaesthesia and intravenous sedation, using the rigid pleuroscope (KARL STORZ, Germany). ROSE with the Hemacolor rapid staining method and cytological examination with Papanicolaou staining method from MT biopsy specimens was performed. The final diagnosis was established following histopathological examination.Results: Thirty patients were enrolled in the study. Thoracoscopic pleural biopsies were diagnostic in 29 patients (96.6%). The final diagnoses were: malignant mesothelioma (n=8), metastatic lung cancer (n=5), tuberculosis (n=1), benign asbestos exposure (n=1), parapneumonic effusions (n=10) and non specific pleuritis (n=5). The accuracy of ROSE in predicting the final diagnosis of malignancy was 82%. ROSE had a sensitivity of 66%, specificity of 94%, positive predictive value of 88% and negative predictive value of 80%. The cytological examination with Papanicolaou method showed similar diagnostic accuracy.Conclusion: ROSE during MT was helpful for predicting malignancy. ROSE can result in shorter procedures reducing the number of biopsies required and can be a useful tool in thoracoscopist's decision making for pleurodesis, especially in cases with inconclusive macroscopic appearance. ER -