Pleural Touch Preparations and Direct Visualization of the Pleura during Medical Thoracoscopy for the Diagnosis of Malignancy

• DOI: 10.1513/annalsats.201701-056oc
• Publication Date: 2017-04-13T18:58:18Z
• Authors: Horiana B. Grosu; Macarena Vial-Rod...; Erik Vakil; Roberto F. Casal; George A. Eapen; Rodolfo Morice; John Stewart; Mona G. Sarkiss; David E. Ost
• Keywords: Thoracoscopy; Parietal Pleura

During diagnostic thoracoscopy, talc pleurodesis after biopsy is appropriate if the probability of malignancy sufficiently high. Findings on direct visual assessment pleura during rapid onsite evaluation (ROSE) touch preparations (touch preps) thoracoscopic specimens, and preoperative imaging may help predict likelihood malignancy; however, data performance these methods are limited.To assess ROSE preps, in diagnosing malignancy.Patients who underwent preps thoracoscopy for suspected were retrospectively reviewed. Malignancy was diagnosed basis final pathologic examination pleural specimens. results categorized as malignant, benign, or atypical cells. Visual tumor studding present absent. Positron emission tomography (PET) computed (CT) findings abnormal normal pleura. Likelihood ratios calculated each category test result.The study included 44 patients, 26 (59%) with a diagnosis malignancy. follows: preps: 1.97 (95% confidence interval [CI], 0.90-4.34); cells, 0.69 CI, 0.21-2.27); 0.11 0.01-0.93); assessment: present, 3.63 1.32-9.99); absent, 0.24 0.09-0.64); PET: pleura, 9.39 1.42-62); 0.11-0.52); CT: 13.15 1.93-89.63); 0.28 0.15-0.54).A finding no malignant cells lowers significantly, whereas only moderately increases A positive PET and/or CT significantly moderate-risk patient group can be used an adjunct to before pleurodesis.