open access

Vol 87, No 5 (2019)
ORIGINAL PAPERS
Published online: 2019-10-31
Submitted: 2019-03-15
Accepted: 2019-08-06
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Thoracoscopic pleural brushing — an innovative method of pleural sampling in diagnostic medical thoracoscopy

Yuvarajan Sivagnaname, Praveen Radhakrishnan, Antonious Maria Selvam
DOI: 10.5603/ARM.2019.0046
·
Pubmed: 31680224
·
Adv Respir Med 2019;87(5):257-260.

open access

Vol 87, No 5 (2019)
ORIGINAL PAPERS
Published online: 2019-10-31
Submitted: 2019-03-15
Accepted: 2019-08-06

Abstract

Introduction: Pleural biopsy is the commonest mode of obtaining thoracoscopic pleural specimens from suspected pleural lesions. However, this may be associated with a risk of bleeding in certain cases. The decision to perform biopsy could be difficult, especially when the lesions are close to vascular structures and the visceral pleura. So, pleural brushing can be used to get safely thoracoscopic specimens in addition to biopsy samples. Aim: To determine the sensitivity and specificity of thoracoscopic pleural brushing in exudative pleural effusions. Material and methods: This prospective study was done in the Department of Pulmonary Medicine, Sri Manakula Vinayagar Medical College, Pondicherry, India on 80 patients with exudative pleural effusion in whom pleural fluid analysis and closed pleu-ral biopsy results were inconclusive. All these patients were subjected to medical thoracoscopy after getting informed consent. Pleural biopsy and pleural brushings were taken and sent for analysis. Results: Thoracoscopic pleural biopsy was diagnostic in 76 of 80 patients (95%). Thoracoscopic pleural brushing was diagnostic in 74 patients (92.5%). Histopathology revealed malignancy (82.7%), granulomatous inflammation (11.5%) and nonspecific inflam-mation (5.7%). The sensitivity and specificity of pleural brushing were 96% and 75%, respectively. Interestingly, pleural brushing was the only diagnostic modality in one patient that was reported to be adenocarcinoma. Conclusions: Thoracoscopic pleural brushing is an easy, convenient and safe procedure as it can augment the diagnostic yield of thoracoscopy. It is of significant value, especially in sampling pleural lesions close to vessels and the visceral pleura compared to pleural biopsy.

Abstract

Introduction: Pleural biopsy is the commonest mode of obtaining thoracoscopic pleural specimens from suspected pleural lesions. However, this may be associated with a risk of bleeding in certain cases. The decision to perform biopsy could be difficult, especially when the lesions are close to vascular structures and the visceral pleura. So, pleural brushing can be used to get safely thoracoscopic specimens in addition to biopsy samples. Aim: To determine the sensitivity and specificity of thoracoscopic pleural brushing in exudative pleural effusions. Material and methods: This prospective study was done in the Department of Pulmonary Medicine, Sri Manakula Vinayagar Medical College, Pondicherry, India on 80 patients with exudative pleural effusion in whom pleural fluid analysis and closed pleu-ral biopsy results were inconclusive. All these patients were subjected to medical thoracoscopy after getting informed consent. Pleural biopsy and pleural brushings were taken and sent for analysis. Results: Thoracoscopic pleural biopsy was diagnostic in 76 of 80 patients (95%). Thoracoscopic pleural brushing was diagnostic in 74 patients (92.5%). Histopathology revealed malignancy (82.7%), granulomatous inflammation (11.5%) and nonspecific inflam-mation (5.7%). The sensitivity and specificity of pleural brushing were 96% and 75%, respectively. Interestingly, pleural brushing was the only diagnostic modality in one patient that was reported to be adenocarcinoma. Conclusions: Thoracoscopic pleural brushing is an easy, convenient and safe procedure as it can augment the diagnostic yield of thoracoscopy. It is of significant value, especially in sampling pleural lesions close to vessels and the visceral pleura compared to pleural biopsy.

Get Citation

Keywords

pleural brushing, medical thoracoscopy, pleural biopsy

About this article
Title

Thoracoscopic pleural brushing — an innovative method of pleural sampling in diagnostic medical thoracoscopy

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 5 (2019)

Pages

257-260

Published online

2019-10-31

DOI

10.5603/ARM.2019.0046

Pubmed

31680224

Bibliographic record

Adv Respir Med 2019;87(5):257-260.

Keywords

pleural brushing
medical thoracoscopy
pleural biopsy

Authors

Yuvarajan Sivagnaname
Praveen Radhakrishnan
Antonious Maria Selvam

References (8)
  1. Ali I. Comparison between the diagnostic yields of thoracoscopic brush pleural biopsy and medical thoracoscopic forceps biopsy in patient with undiagnosed pleural effusion. MD Thesis, Alexandria University, Faculty of Medicine, 2011.
  2. Shaaban L, Ahmed Y. Value of thoracoscopic pleural brush in the diagnosis of exudative pleural effusion. Egyptian J Chest Dis Tuberculosis. 2012; 61(4): 385–389.
  3. Casal RF, Eapen GA, Morice RC, et al. Medical thoracoscopy. Curr Opin Pulm Med. 2009; 15(4): 313–320.
  4. Kendall S, Bryan AJ, Large SR, et al. Pleural effusions: is thoracoscopy a reliable investigation? A retrospective review. Respir Med. 1992; 86(5): 437–440.
  5. Tscheikuna J, Silairatana S, Sangkeaw S, et al. Outcome of medical thoracoscopy. J Med Assoc Thai. 2009; 92 (Suppl. 2): 19–23.
  6. Elameen M, Khalid K. Medical thoracoscopy: a useful minimal invasive procedure . Egyptian J Chest Dis Tuberculosis. 2012; 61: 159–163.
  7. El Halfway A. The role of fiberoptic medical thoracoscope in the diagnosis of pleural effusion. MD Thesis, Faculty of Medicine, Cairo University, 2001.
  8. Khames A, Zamzam M, S E. Role of thoracoscopic pleural lavage and brush in undiagnosed exudative pleural effusion. Eur Resp J. 2016; 48 (Suppl. 60).

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