Diagnostic approach to pleural diseases: new tricks for an old trade

Abstract

The burden of pleural diseases has substantially increased in the past decade because of a rise in the incidence of pleural space infections and pleural malignancies in a patient population that is older and more immunocompromised and has more comorbidities. This complexity increasingly requires minimally invasive diagnostic options and tailored management. Implications for patients are such that the limitations of current diagnostic methods need to be addressed by multidisciplinary teams of investigators from the fields of imaging, biology, and engineering. Ignored for a long time as an epiphenomenon at the crossroad of many unrelated medical problems, pleural diseases are finally getting the attention they deserve and have spurred a vibrant and exciting field of research.

Pleural cryobiopsy during local anaesthetic thoracoscopy in dry pleural dissemination

“…Proposed advantages of LAT using flexrigid thoracoscope include ease of manoeuvrability in the pleural space, smaller incision site and lower anaesthetic requirements; with sensitivity of 91%, specificity of 100%, and 1.5% rate of major complications [1]. LAT allows pleural exploration and biopsies in conscious patients, and is safe and effective diagnostic modality [2], with high diagnostic accuracy as reported [3,4]. However, there is shortage of published data regarding the efficacy and safety of LAT in the absence of pleural fluid, either with or without use of TUS as procedural adjunct [5,6].…”

Mortality Among Hospitalized Patients With Pleural Effusions. A Multicenter, Observational, Prospective Study

“…Pleural effusion (PE) is a common clinical condition, arising from a variety of systemic, malignant, infectious, and inflammatory diseases. It affects 1.5 million patients per year in the USA ( 1 ) and 200,000–250,000 in the UK ( 2 ) with an increasing burden following an aging population with more comorbidities ( 3 ). It has been established that PE significantly affects prognosis and mortality, depending on etiology.…”

Caracterización integral del derrame pleural en un hospital de referencia del sureste de México

“…La integración de los resultados permitará acortar el diagnóstico diferencial e iniciar un tratamiento oportuno. 7 En Estados Unidos se estima que 1,5 millones de personas desarrollan DP cada año; de éstos, la principal causa es por insuficiencia cardíaca. 8 Por otro lado, en España, el análisis de más de 3,000 toracocentesis permitió identificar que la principal causa de DP era la relacionada con derrames paraneoplásicos.…”