@article {AltmanP3073, author = {Edward Altman and Larisa Spiridonov and Sonkin Vadim and Livoff Alejandro and Gavrilov Alexei and Cohen I. Hector}, title = {Efficacy of cytology, cell blocks and thoracoscopic pleural biopsy in malignant pleural effusion diagnosis}, volume = {42}, number = {Suppl 57}, elocation-id = {P3073}, year = {2013}, publisher = {European Respiratory Society}, abstract = {Introduction: Thoracocentesis and cytological examination with cell blocks are considered optimal for malignant pleural effusion (MPE) diagnosis. No study has separately evaluating efficacy of these two methods compared with thoracoscopic pleural biopsy.Objectives: To compare diagnostic efficacy of thoracocentesis with cytological examination of pleural fluid intensified by cell blocks with surgical thoracoscopic pleural biopsy and histological examination of specimen. To reduce diagnostic time.Methods: Retrospective review of 115 MPE patients in Western Galilee Hospital from 2001-2011. MPE diagnosis was established by thoracocentesis, cytological examination of fluid with cell blocks. Thoracoscopy, pleural biopsy and histological examination were done in cases of false negative or inconclusive cytology.Results: Of 115 patients 60 were male, 55 female; mean age 67.8y. Cytological examination of pleural fluid was positive in 85.7\% of 28 breast carcinoma cases, 79.5\% of 39 bronchogenic carcinomas, 61.9\% of 21 other malignancies. Use of cell blocks increased positive results in 3-12\%. Mesothelioma (27 cases) cytological results were inconclusive.Thoracoscopy was performed in 64 patients. Histological diagnosis was done in 100 \%. Mean duration of diagnostic process was 12.58 days in 85 patients., but longer in others due to repeated thoracocentesis, again with false negative results.Conclusions: Cytological examination of pleural fluid in MPE patients was diagnostically effective (61.9-85.7\%) except for mesothelioma. Cell blocks increased positive results.Thoracoscopy with pleural biopsy in cases of negative or inconclusive cytological results was very effective (100\%).}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/P3073}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/P3073.full.pdf}, journal = {European Respiratory Journal} }