Incidence of malignancy and survival in patients with idiopathic pleuritis

Reuter, Simon; Clementsen, Paul Frost; Bødtger, Uffe

doi:10.21037/jtd.2018.12.136

Cited by 20 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The malignancies diagnosed during follow-up were one mesothelioma, two gynaecological cancers, one primary renal cell cancer and one cancer of unknown primary tumour. So, in our study, there seems to be no specific primary cancer type that is missed frequently, in contradiction with the data of several other studies, in which frequently malignant mesothelioma or metastatic pulmonary carcinoma were diagnosed 9 14–16…”

Section: Discussioncontrasting

confidence: 99%

“…This is also comparable to two other studies, in which both 5% of malignancy was diagnosed during follow-up,14 15 however, in other studies up to 25% of malignancy was found,22 23 in the latter after a mean period of 6 months. In another study in a tertiary referral hospital with high incidence of mesothelioma 12% showed to have malignant pleural effusion, all of them mesothelioma related, and mean follow-up until diagnosis was 9.8 (±4.6) months 24.…”

Section: Discussionsupporting

confidence: 91%

“…Most malignancies are diagnosed within 1 year after thoracoscopy, and rarely later. Number needed to detect one malignancy during the first year after thoracoscopy was calculated as 18, and afterwards 250 15 17 25…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic value and safety of thoracoscopic pleural biopsies in pleural exudative effusions of unknown origin, including follow-up

Deschuyteneer¹,

Keukeleire

2022

BMJ Open Resp Res

View full text Add to dashboard Cite

IntroductionPleural exudative effusions without diagnosis after initial work up are a frequent problem in any respiratory division. Several ways to obtain pleural biopsy exist. Thoracoscopy is one of the most frequently used. Differential diagnosis mainly exists out of malignant pleuritis, tuberculosis, nonspecific pleuritis and rarely systemic or autoimmune disease. We performed a retrospective data analysis of our almost 10-year period experience, the first Belgian data to be published.MethodsWe performed a retrospective data analysis of all patients with unexplained pleural exudates who underwent diagnostic medical thoracoscopy under general anaesthesia in our respiratory department during the period 2006–2015. We report on diagnoses made, sensitivity and specificity, safety of thoracoscopy and follow-up of patients after thoracoscopy.Results131 patients underwent diagnostic medical thoracoscopy during the inclusion period. 44.3% (n=58) of the patients were diagnosed with malignant pleuritis, 45.0% (n=59) with nonspecific pleuritis, 7.6% (n=10) with tuberculous pleuritis and some with other benign conditions. Complications are comparable to other data published. Six months follow-up of patients with non-specific pleuritis reveal 8.5% (n=5) of these patients to have malignant pleuritis, and another 8.5% (n=5) with infectious or other benign conditions.ConclusionMedical thoracoscopy under general anaesthesia for diagnostic work up of pleural exudates of unknown origin generally has a high diagnostic yield. It is generally safe, certainly compared with the information it delivers. During follow-up, minority of patients with nonspecific pleuritis will prove to be malignant in origin, benign or autoimmune disease related.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Diagnostic value and safety of thoracoscopic pleural biopsies in pleural exudative effusions of unknown origin, including follow-up

Deschuyteneer¹,

Keukeleire

2022

BMJ Open Resp Res

View full text Add to dashboard Cite

show abstract

“…Various datasets have described a finding of NSP following pleural biopsy, with a mean incidence of 40%, 95% CI (38 -41%). [2][3][4][5][6][7][8][9][10][11][12][13][14][15] The pathophysiological mechanisms underpinning NSP are poorly understood, and it may simply represent a final common inflammation or fibrotic pathway. There are no prospective databases on NSP, and all the evidence so far is based on single centre, retrospective studies.…”

Section: Introduction (2958/3000 Words)mentioning

confidence: 99%

Investigation and outcomes in patients with nonspecific pleuritis: results from the International Collaborative Effusion database

Sundaralingam¹,

Aujayeb

Jackson

et al. 2023

ERJ Open Res

Self Cite

View full text Add to dashboard Cite

IntroductionWe present findings from the International Collaborative Effusion database, an ERS clinical research collaboration. Non-specific pleuritis (NSP) is a broad term that describes chronic pleural inflammation. Various aetiologies lead to NSP, which poses a diagnostic challenge for clinicians. A significant proportion of patients with this finding eventually develop a malignant diagnosis.Methods12 sites across 9 countries contributed anonymised data on 187 patients. 175 records were suitable for analysis.ResultsThe commonest aetiology for NSP was recorded as Idiopathic (80/175, 44%). This was followed by pleural infection (15%), benign asbestos disease (12%), malignancy (6%) and cardiac failure (6%). The malignant diagnoses were predominantly mesothelioma (6/175, 3.4%) and lung adenocarcinoma (4/175, 2.3%). The median time to malignant diagnosis was 12.2 months (range 0.8–32). There was a signal towards greater asbestos exposure in the malignant NSP group compared to the benign group (0.63versus0.27, p=0.07). Recurrence of effusion requiring further therapeutic intervention, nor initial biopsy approach were associated with a false negative biopsy. A computed tomography finding of a mass lesion was the only imaging feature to demonstrate a significant association (0.18versus0.01, p=0.02), though sonographic pleural thickening also suggested an association (0.27versus0.09, p= 0.09).DiscussionThis is the first multi-centre study of NSP and its associated outcomes. Whilst some of our findings are reflected by the established body of literature, other findings have highlighted important areas for future research, not previously studied in NSP.

show abstract

“…Moreover, MPE can be mimicked by other common causes of exudative pleural effusion such as pleural tuberculosis (TB) and parapneumonic effusion [5]. Thus, there is an increasing need to discover non-invasive biomarkers to diagnose or rule-out MPE accurately and e ciently in clinical practice [6].…”

mentioning

confidence: 99%

Pro-cathepsin D as a diagnostic marker in differentiating malignant from benign pleural effusion: A retrospective cohort study

Choi

Lee

2020

Preprint

View full text Add to dashboard Cite

Background: Malignant pleural effusion (MPE) causes substantial symptomatic burden in advanced malignancy. Although pleural fluid cytology is a commonly accepted gold standard of diagnosis, its low diagnostic yield is a challenge for clinicians. The aim of this study was to determine whether pro-cathepsin D can serve as a novel biomarker to discriminate between MPE and benign pleural effusion (BPE).Methods: This study included 81 consecutive patients with exudative pleural effusions who had underwent thoracentesis or pleural biopsy. Pleural fluid and serum were collected as a standard procedure for all individuals at the same time. The level of pro-cathepsin D was measured by the sandwich enzyme-linked immunosorbent assay method.Results: Though there were no significant differences in plasma pro-cathepsin D between the two groups, the level of pleural fluid pro-cathepsin D was signiﬁcantly higher in the MPE group than the BPE group (0.651 versus 0.590 pg/mL, P = 0.034). The discriminative power of pleural fluid pro-cathepsin D for diagnosing MPE was moderate, with 81% sensitivity and 53% specificity at a pro-cathepsin D cut-off ≥0.596 pg/mL (area under the curve: 0.656). Positive and negative predictive values for MPE were 38% and 89%, respectively, with pro-cathepsin D cut-off value (>0.596 pg/mL).Conclusions: The level of pleural fluid pro-cathepsin D was found to be significantly higher in MPE than in BPE. Although results of this study could not support the sole use of pleural fluid pro-cathepsin D to diagnose MPE, pleural fluid pro-cathepsin D can be added to pre-existing diagnostic methods for ruling-in or ruling-out MPE.

show abstract

Incidence of malignancy and survival in patients with idiopathic pleuritis

Cited by 20 publications

References 21 publications

Diagnostic value and safety of thoracoscopic pleural biopsies in pleural exudative effusions of unknown origin, including follow-up

Diagnostic value and safety of thoracoscopic pleural biopsies in pleural exudative effusions of unknown origin, including follow-up

Investigation and outcomes in patients with nonspecific pleuritis: results from the International Collaborative Effusion database

Pro-cathepsin D as a diagnostic marker in differentiating malignant from benign pleural effusion: A retrospective cohort study

Contact Info

Product

Resources

About