Undiagnosed pleural effusion : outcome and differentiation from malignant pleural effusion

등록일 2018.12.06 파일확장자어도비 PDF (pdf) | 1페이지 | 가격 1,000원
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발행기관 : 대한결핵 및 호흡기학회 수록지정보 : 대한결핵및호흡기학회 추계학술발표초록집 / 126권
저자명 : 이혜진 , 최선하 , 서혜원 , 유승수 , 이신엽 , 차승익 , 김창호 , 박재용 , 이재희

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Background: The cause of pleural effusion is not always evident following diagnostic thoracentesis and pleural biopsy. In patients with undiagnosed pleural effusion (UPE), there is concern about the possibility of missing malignant pleural effusion (MPE). However, there is a few data regarding outcome in these cases.Methods: Patients who underwent pleural biopsy by video-assisted thoracoscopic surgery (VATS) between 2010 and 2017 were retrospectively reviewed. Clinical, laboratory, radiologic data were compared between UPE and MPE and outcome was assessed in those with UPE.Results: During the study period, 116 patients underwent VATS pleural biopsy for diagnostic purpose. Based on the histologic results, tuberculous pleural effusion, MPE, and miscellaneous effusion cases were diagnosed in 44, 23, and 3 patients, respectively. Remaining 46 patients had non-specific pleuritis. Eventually, UPE was the final diagnosis in 23 patients after excluding 23 having relevant causes found subsequently. Twenty three patients with UPE and 23 MPE were compared. Pleural nodularity on chest CT was independently associated with MPE. In patients with UPE, no specific diagnosis was given in 22 (96%) patients during the follow-up period (mean 33 months). Among them, 10 showed resolution of effusion, while 12 had no change. Only a patient was subsequently diagnosed as malignant mesothelioma.Conclusions: A fifth of patients remain undiagnosed despite invasive pleural biopsy. Most of them have a benign clinical course, but presence of pleural nodularity indicates need for close observation.

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      Undiagnosed pleural effusion : outcome and differentiation from malignant pleural effusion
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