Document Detail


Frozen section of pleural biopsies at medical thoracoscopy assists in correctly identifying benign disease.
MedLine Citation:
PMID:  16268918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Medical thoracoscopy and thoracoscopic talc poudrage (TTP) are accepted procedures in the management of pleural effusions. The relative merits of TTP compared with pleurodesis via intercostal catheter (ICC) continue to be debated. However, of the two procedures, only medical thoracoscopy allows both tissue diagnosis and pleurodesis to be achieved reliably in one procedure. The aim of this study was to assess the feasibility and accuracy of using frozen section analysis of samples taken during medical thoracoscopy to assist the thoracoscopist's decision to complete the procedure with a TTP. METHODOLOGY: Twenty patients with undiagnosed pleural effusions after at least one diagnostic pleurocentesis underwent medical thoracoscopy and biopsy. RESULTS: Frozen sections were easily performed within the timeframe of medical thoracoscopy. The final diagnosis based on paraffin sections was malignant in 10 cases and benign in 10 cases. Frozen section at the time of thoracoscopy (before TTP) correctly identified nine of 10 cases as being benign and six of 10 cases as malignant. In the malignant group, reasons for incorrect identification as benign were sampling from superficial benign adipose tissue overlying the malignant deposits, difficult access to the most involved parts of the pleura and intense cellular infiltrate initially thought to be benign. CONCLUSION: Frozen sections taken during medical thoracoscopy have the potential to facilitate decision-making prior to pleurodesis, particularly for accurate identification of benign histology on thoracoscopic pleural biopsies, in order that pleurodesis is not performed unnecessarily.
Authors:
David Fielding; Peter Hopkins; David Serisier
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  10     ISSN:  1323-7799     ISO Abbreviation:  Respirology     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-04     Completed Date:  2006-02-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  636-42     Citation Subset:  IM    
Affiliation:
Department of Thoracic Medicine, Royal Brisbane Hospital, Australia. david_fielding@health.qld.gov.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biopsy / methods
Chronic Disease
Diagnosis, Differential
Feasibility Studies
Female
Frozen Sections*
Humans
Male
Middle Aged
Perioperative Care*
Pleural Effusion / pathology*
Pleural Effusion, Malignant / pathology
Pleurodesis
Predictive Value of Tests
Thoracoscopy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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