Long-term Outcome Of Patients With Nonspecific Pleurisy At Medical Thoracoscopy

Background: Medical thoracoscopy is an effective and safe procedure for diagnosing pleural effusions of undetermined causes.But there are still a part of patients with pleural effusions were diagnosed as nonspecific pleurisy when no specific biopsy results were found after undergoing thoracoscopic biopsy.The long-term outcome of these patients is unclear,and anxieties about undiagnosed malignancy persist.Methods: Between July 2005 and June 2014,medical thoracoscopy using the semi-rigid instrument was performed and pleural biopsy was taken in 833 patients with pleural effusions.Fifty-two patients diagnosed with nonspecific pleurisy with available follow-up data were included in the present study and their medical records were reviewed.Results: Fifty-two patients(31 men and 21 women)were included.Mean follow up was 35.5 ± 40.9 months(range,1 to 143 months).No specific diagnosis was established in 21(40.4%)of the patients.Eight of 52 patients with nonspecific pleurisy(15.4%)were subsequently diagnosed with pleural malignancies.23 of 52 patients(44.2%)were diagnosed as benign diseases.The recurrence of pleural effusion during followed-up and pleural nodules or plaques found in medical thoracoscopy was associated with malignant disease.Conclusion: Patients with nonspecific pleurisy after medical thoracoscopy should be closely monitored,especially in those patients with the recurrence of pleural effusion during followed-up,pleural nodules or plaques found in medical thoracoscopy.One year of clinical follow-up for patients found to have nonspecific pleurisy is likely sufficient.