Browse > Article

Diagnostic Accuracy of 2-mm Minithoracoscopic Pleural Biopsy for Pleural Effusion  

Kim, Woo Jin (Department of Internal Medicine, College of Medicine, and Medical Science Institute, Kangwon National University)
Lee, Hui Young (Department of Internal Medicine, College of Medicine, and Medical Science Institute, Kangwon National University)
Lee, Sung Ho (Department of Chest Surgery, College of Medicine, and Medical Science Institute, Kangwon National University)
Cho, Seong Joon (Department of Chest Surgery, College of Medicine, and Medical Science Institute, Kangwon National University)
Park, Weon-Seo (Department of Pathology, College of Medicine, and Medical Science Institute, Kangwon National University)
Kim, Ja Kyoung (Department of Pediatrics, College of Medicine, and Medical Science Institute, Kangwon National University)
Lee, Seung-Joon (Department of Internal Medicine, College of Medicine, and Medical Science Institute, Kangwon National University)
Publication Information
Tuberculosis and Respiratory Diseases / v.57, no.2, 2004 , pp. 138-142 More about this Journal
Abstract
Background : To evaluate exudative pleural fluid, thoracentesis for microbiological and cytological examination and pleural biopsy by using a Cope needle are traditionally performed. Even after these studies, about 20% of patients remain undiagnosed. We evaluated the diagnostic accuracy and complications of 2-mm minithoracoscopy instead of blind biopsy in patients with undiagnosed exudative pleural effusion. Method : Fifteen patients with exudative pleural effusion underwent thoracoscopy between April 2002 and August 2003. The indication was undiagnosed pleural effusions after having performed sputum and pleural fluid exami-nations both microbiologically and cytologically. Results : The median age of the patients was 56 years (range 21-77). Pleural effusions were lymphocyte-dominant in 11 patients (73.3%) and neutrophil-dominant in 3 (20.0%). The remaining patient (6.7%) had pleural-fluid eosinophilia. Minithoracoscopic biopsy revealed accurate diagnosis in 14 patients (93.3%), consisting of tuberculous pleurisy in 8 (66.7%), malignant effusions in 4 (33.3%), and parapneumonic effusions in 2 (13.3%). One was diagnosed as having paragonimiasis from thoracoscopic findings and clinical considerations. There was no procedure-associated mortality. There were six cases of new onset fever (40%) and one of pneumothorax (6.7 %). Conclusion : Two-millimeter minithoracoscopy, which is less invasive than conventional thoracoscopy, was an accurate and safe method for undiagnosed exudative pleural effusion.
Keywords
Pleural effusion; Minithoracoscopy; Biopsy; Diagnosis; Accuracy;
Citations & Related Records

Times Cited By SCOPUS : 1
연도 인용수 순위
1 Maskell NA, Butland RJ. BTS guidelines for the investigation of a unilateral leural effusion in adults. Thoax 2003;58(suppl II):ii8-17
2 Roh GH, Kang SJ, Youn JW, Hwang JH, Ham HS, Kang EH, et al. Clinical characteristics and diagnostic utility of eosinophilic pleural effusion. Tuberc Respir Dis 2000;49:733-9
3 Yim AP. Thoracoscopy and video-assisted thoracic surgery. Curr Opin Pulm Med 1999;5:256-8
4 Loddenkemper R. Thoracoscopy-state of the art. Eur Respir J 1998;11:213-21
5 Tassi G, Marchetti G. Minithoracoscopy. Chest 2003; 124:1975-7
6 Malthaner RA, Inculet RI. Minithoracoscopy for pleural effusions. Can Respir J 1998;5:253-4
7 Boutin C, Astoul P, Seitz B. The role of thoracoscopy in the evaluation and management of pleural effusions. Lung 1990;168 Suppl:1113-21
8 Light RW. Clinical practrce Pleural effusion. N Engl J Med 2002;346:1971-7
9 Menzies R, Charbonneau M. Thoracoscopy for the diagnosis of pleural disease. Ann Intern Med 1991;114:271-6
10 Canto A, Ferrer G, Romagosa V, Moya J, Bernat R.Lung cancer and pleural effusion: clinical significance and study of pleural metastatic locations. Chest1985;87:649-52
11 Loddenkemper R, Schonfeld N. Medical thoracoscopy. Curr Opin Pulm Med 1998;4:235-8