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Diagnostic and Therapeutic Endoscopy
Volume 3, Issue 3, Pages 147-151
http://dx.doi.org/10.1155/DTE.3.147

Thoracoscopy in Pleural Malignant Mesothelioma Diagnosis

1Division of Pneumology, Valle Camonica Hospital, Esine (Brescia) 25040, Italy
2Service of Pathologic Anatomy, Valle Camonica Hospital, Esine (Brescia) 25040, Italy

Received 6 June 1996; Revised 9 July 1996; Accepted 7 August 1996

Copyright © 1997 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

On the basis of our personal experience in 70 cases (66 pleural effusions) observed during the period January 1984- January 1996 we are here illustrating and discussing the diagnostic role of thoracoscopy in malignant pleural mesothelioma.

A histological diagnosis was achieved in 94.2% of cases. The endoscopic appearance was clearly neoplastic (masses, nodules) in 53 patients (75.7%) and simply inflammatory in 17 pachypleuritis in 13 (18.6%) and of diffuse hyperemia in 3 (5.7%). In all cases fluid cytology (diagnostic yield: 18.5%) and needle biopsy (diagnostic yield 17.1%) were performed.

The extension of pleural involvement (endoscopic staging according to Boutin) was also determined. In 16 patients (22.8%) a parietal and diaphragmatic involvement (stage Ia) was found. In 40 patients (57.2%) an associated visceral invasion (stage Ib). In 14 cases (20%) a diffuse parietal, visceral and mediastinal extension (stage II). The exam has always been well tolerated with few immediate complications: subcutaneous emphysema (4 cases) and some negligeable parietal bleeding (2 cases).