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

Updated: Apr 18, 2019
  • Author: Rajiv Malhotra, DO, MS, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

Lung Cancer

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 (see the images below).

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 to 62% for cytology from thoracentesis and 44% for closed pleural biopsy. [10] By allowing for more accurate diagnosis and staging, this may help prevent unnecessary procedures on a patient who is inappropriately categorized into a lower stage.


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