Use of cryobiopsy-assisted videopleuroscopy in the diagnosis of pleural mesothelioma - preliminary reports
J. Pieróg*a (Prof), W. Głazeka (Dr), K. Safranowa (Prof), K. Ptaszyńskia (Prof), J. Wójcika (Prof), M. Wojtyśa (Dr), M. Szaja (Dr), K. Witkiewicza (Dr), B. Kubisaa (Prof)
a Pomeranian Medical University, Szczecin, POLAND
Pleural mesothelioma is not a common malignant neoplasm but its diagnosis and treatment are still unsatisfactory.
The study enrolled 71 patients who were clinically suspected of having pleural mesothelioma due to the presence of pleural fluid and due to chest CT findings. Each patient underwent a pleural ultrasound to determine the amount of fluid in the pleura prior to videopleuroscopy. 20 ml of 1% lignocaine was anesthetized at the site of insertion of the videotracker into the pleural cavity. After insertion of the videopleuroscope and aspiration of pleural fluid, the parietal and visceral pleura were assessed macroscopically. Then forceps and a 1.9 mm cryoprobe were inserted through the 2 mm working channel of the videopleuroscope, which were placed near the lesions in the mural pleura and tissue material was collected. Subsequently, a 28 F drain was introduced through the hole to drain the pleural cavity. The following day, each patient underwent a chest radiograph to assess the presence of pneumothorax and lung expansion after pleural biopsy.
During histopathological evaluation of the tissue material, a diagnosis of pleural mesothelioma was directly confirmed in 11 of 71 patients, representing 15.5% of the total number of patients. In other patients, the histopathological diagnosis did not indicate pleural mesothelioma.
The use of cryobiopsy-assisted videopleuroscopy is a useful, promising and minimally invasive diagnostic option to obtain representative tissue material suitable for cytogenetic and immunohistochemical studies to confirm the diagnosis of pleural mesothelioma. However, assessment of its clinical usefulness requires further studies and an increase in the number of patients in whom it has been performed.
Disclosure of funding source(s): none