title: Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion.
abstract: BACKGROUND
  Differentiating tuberculous pleural effusion from other lymphocytic pleural effusions is often challenging. This retrospective study aimed to assess the efficacy and safety of medical thoracoscopy in patients with suspected tuberculous pleural effusion.
  
  
  METHODS
  Between July 2005 and June 2014, patients with pleural effusions of unknown etiologies underwent medical thoracoscopy in our institute after less invasive means of diagnosis had failed. Demographic, radiographic, procedural, and histological data of patients with tuberculous pleural effusion were analyzed.
  
  
  RESULTS
  During this 9-year study, 333 of 833 patients with pleural effusion were confirmed to have tuberculous pleurisy. Under thoracoscopy, we observed pleural nodules in 69.4%, pleural adhesion in 66.7%, hyperemia in 60.7%, plaque-like lesions in 6.0%, ulceration in 1.5% of patients with tuberculous pleurisy. Pleural biopsy revealed the presence of Mycobacterium tuberculosis in the pleural tissue or/and demonstration of caseating granulomas in 330 (99.1%) patients. No serious adverse events were recorded, and the most common minor complication was transient chest pain (43.2%) from the indwelling chest tube.
  
  
  CONCLUSIONS
  Our data showed that medical thoracoscopy is a simple procedure with high diagnostic yield and excellent safety for the diagnosis of tuberculous pleural effusion.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Xu
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Yan-Bing
authors.initials: YB
authors.lastname: Wu
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiao-Juan
authors.initials: XJ
authors.lastname: Wang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. Electronic address: tongzhh@hotmail.com.
authors.forename: Zhao-Hui
authors.initials: ZH
authors.lastname: Tong
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. Electronic address: shihuanzhong@sina.com.
authors.forename: Huan-Zhong
authors.initials: HZ
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology; D010996:Pleural Effusion / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014396:Tuberculosis, Pleural / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology
keywords: Medical thoracoscopy; Pleural biopsy; Tuberculous pleural effusion