Outcome of patients diagnosed with fibrinous pleuritis after medical thoracoscopy

Respir Med. 2012 Aug;106(8):1177-83. doi: 10.1016/j.rmed.2012.04.009. Epub 2012 May 17.


Background: In patients with post- medical thoracoscopy histopathological diagnoses of fibrinous pleuritis, confusion can occur concerning subsequent procedures. This issue is particularly important in regions where mesothelioma is prevalent. We aimed to identify false negatives among patients where mesothelioma was common due to asbestos exposure whose histopathological diagnosis following thoracoscopy was fibrinous pleuritis. We also determined risk factors associated with patients that required additional advanced invasive procedures for diagnosis.

Methods: Overall, 287 patients who underwent thoracoscopy were included in the study. Patients diagnosed with fibrinous pleuritis as a result of thoracoscopy were followed for 2 years regarding this condition. More invasive procedures were performed on patients who showed no recuperation or developed pleural disease again during the follow-up period.

Results: Fibrinous pleuritis was observed in 101 (35.2%) patients. Follow-up of these patients revealed that the false negative rate was 18% for malignant pleural diseases. The thoracoscopist's opinion regarding the pleural space, computed tomography scan findings indicating malignancy, pain and female gender were determined to be risk factors for malignant pleural diseases.

Conclusions: In regions where mesothelioma is prevalent and one of the above-stated risk factors is present, patients whose post-thoracoscopy histopathological diagnosis is fibrinous pleuritis should be treated with a more advanced invasive diagnosis procedure.

MeSH terms

  • Aged
  • Asbestos / adverse effects
  • Diagnosis, Differential
  • False Negative Reactions
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mesothelioma / diagnosis
  • Mesothelioma / etiology
  • Middle Aged
  • Pleural Effusion, Malignant / diagnosis
  • Pleural Neoplasms / diagnosis
  • Pleural Neoplasms / etiology
  • Pleurisy / diagnosis*
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects
  • Thoracoscopy / methods*
  • Tomography, X-Ray Computed


  • Asbestos