What is the role of a medical thoracoscopy (pleuroscopy) in lung cancer staging?

Updated: Jul 08, 2021
  • Author: Shannon E Burke, DO; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

In the patient with known lung cancer and an effusion with a negative cytology, medical thoracoscopy is an excellent tool. It allows for direct visualization of the pleura and a thorough examination for evidence of metastasis.

Bulky metastasis on parietal pleura. Bulky metastasis on parietal pleura.
Examination for evidence of metastasis. Examination for evidence of metastasis.

The sensitivity of pleuroscopy-guided biopsy in malignant pleural effusions is 95%, compared with 62% for cytology from thoracentesis and 44% for closed pleural biopsy. [10]  By allowing for a more accurate diagnosis and staging, unnecessary procedures may be prevented on a patient who is inappropriately categorized into a lower stage.


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