Analysis on clinical features and manifestations under thoracoscopy in elderly patients with tubercular pleurisy
0
Citation
0
Reference
20
Related Paper
Abstract:
Objective To summarize the clinical features and manifestations under thoracoscopy of 41 elderly patients with tubercular pleurisy,and to discuss the importance of medical thoracoscopy for the diagnosis of tubercular pleurisy in the elderly. Methods The clinical features and manifestations under thoracoscopy of 41 patients with tubercular pleurisy in the elderly diagnosed by flexible electron-assisted thoracoscopy and biopsy were retrospectively analyzed. Results The clinical presentations of tubercular pleurisy were atypical in the elderly.Cough(75.6%) and chest tightness and dyspnea(87.8%) were the most common,and the coexistence proportion of both disease(85.4%) and misdiagnosis rate(68.3%) were high.Based on observation of thoracoscopy there were small punctual sarcoidosis(41.5%),one or more sarcoidosis(26.8%),pleural congestion and edema(19.5%) and pleural thickening and fibrinous adhesion(12.2%) in 41 elderly patients.Distribution of the focus lesion was as follows: 46.3% on parietal pleura with posterior,12.2% on anterior,7.3% on lateral,7.3% on diaphragmatic pleura,19.5% diffusively distributed and 7.3% on visceral pleura.There was no serious complication. Conclusions The clinical profiles of tubercular pleurisy are nonspecific in the elderly.To make a definite diagnosis,medical thoracoscopic surgery should be carried out as early as possible.Keywords:
Thoracoscopy
Pleurisy
Parietal Pleura
Cite
Odjective To improve the cognition of the character of tuberculous pleurisy and assess the value of thoracoscopy in the diagnosis of tuberculous pleurisy.Methods Forty-eight tuberculous pleurisy patients diagnosed through electronic-assisted thoracoscopic pleural biopsy were retrospectively studied on its visual aspect under thoracoscope.Results There were 21 patients with one or more sarcoidosis(43.75%),14 patients with diffused granules(29.17%),8 patients with pleural congestive and edema(16.67%) and 5 patients with pleural thickening and adhesions(10.42%) in 48 patients by visual aspect under electronic-assisted thoracoscopy.Distribution of the tuberculous lesion were as follows:18 cases on parietal pleura(37.50%),10 on visceral pleura(20.83%) and 6 on diaphragmatic pleura(12.50%).The other 14 cases were diffused distributed. There was no one serious complication.Conclusion Electronic-assisted thoracoscopic pleural biopsy is relatively safe and has very important value in diagnosis of tuberculous pleurisy.
Thoracoscopy
Parietal Pleura
Pleurisy
Thoracoscope
Cite
Citations (0)
Objective To study the clinical application of medical thoracoscopy in unknown pleural effusion.Method 60 cases unknown pleural effusion were performed with medical thoracoscopy,biopsy were used of in the pleural under medical thoracoscopy.Results Of all 60 cases,57 were diagnosed definitely by pathology,the diagnostic accuracy rate was 95%,among which 6 were malignant tumors(5 adenocarcinoma,1 squamous cell cancer),1 pleural metastasis of rectum,2 pleural mesothelioma,1 lymphocytic lymphoma;46 cases were diagnosed definitely as tuberculous pleurisy(76.66%),3 acidophily granulomatous inflammation,2 nonspecific inflammation,1 empyema,1 showed no abnormalities in pleura.Of 7 bilateral pleural effusion,3 were related with liver flukes,1 with rheumatoid arthritis,1 with systemic lupus erythematosus(SLE),1 were normal without biopsying.Conclusion Medical thoracoscopy is an optimum diagnosis method for unknown pleural effusion.
Thoracoscopy
Cite
Citations (0)
【Objective】To improve the cognition of the character of tuberculous pleurisy and assess the value of thoracoscopy in the diagnosis of tuberculous pleurisy【Methods】Twenty-eight tuberculous pleurisy patients diagnosed through flexi-rigid thoracoscopic pleural biopsy were retrospectively studied on its clinical characteristics.【Results】They are pleural congestion and white military diffused nodes in 2 cases(7.14%),multi white nodes in 13 cases(46.43%),fibrin deposition and adhesion between the parietal and visceral pleura in 12 cases(42.86%),pleural thickness and many of the separation in 1 cases(3.57%).Twenty-five patients(89.29%) were successfully diagnosed by pleural biopsy with pathological examination.There were 14 cases with epithelioid granuloma with necrosis,11 cases with epithelioid cell granuloma,3 cases with chronic inflammation.There was no serious complication.【Conclusion】Electronic-assisted thoracoscopic pleural biopsy is relatively safe and has very important value in diagnosis of tuberculous pleurisy.
Thoracoscopy
Pleurisy
Parietal Pleura
Cite
Citations (0)
Pleural effusion in sarcoidosis is infrequent. The data on thoracoscopic observations of sarcoidosis pleurisy are limited. The present study describes three cases of sarcoid-related pleurisy diagnosed by medical thoracoscopy and discusses the thoracoscopic features of sarcoid pleuritis. The appearance of pleural nodules was completely different in the three cases, and the distribution of nodules of sarcoidosis was heterogenously located in the pleural surfaces. Pleural disease in sarcoidosis could be proved easily by sampling visible nodules, and pleural fluid could be aspirated without complications during thoracoscopy. Due to symptomatic pleurisy of sarcoidosis, therapy was given as systemic corticosteroid. In conclusion, thoracoscopy may be an appropriate alternative technique to obtain an accurate diagnosis in sarcoid pleurisy.
Thoracoscopy
Pleurisy
Pleural thickening
Pleural disease
Cite
Citations (6)
Objective To investigate the morphological features of tuberculous pleurisy under thoracoscopy and evaluate the diagnostic value of thoracoscopy.MethodsRetrospective study were performed on the morphological features and pathological results of 125 patients who had been diagnosed with tuberculous pleurisy by thoracoscopy.Results108 patients(86.4%) were successfully diagnosed by thoracoscope,the other 17 patients were diagnosed with trials of anti-tuberculosis treatment.There were four types of the features of tuberculous pleurisy under thoracoscope,of which 19 patients with pleural congestive and edema,42 patients with diffused granules,40 patients with one or more sarcoidosis,and 24 patients with pleural thickening and adhesions.ConclusionThe morphological features of tuberculous pleurisy are variable,main changes are pleural congestive,edema and diffused granules.The pleural lesions is mainly distributed on costal pleura and diaphragmatic pleura.Thoracoscopy is of great value in the diagnose of tuberculous pleurisy.
Thoracoscopy
Pleurisy
Thoracoscope
Pleural thickening
Cite
Citations (0)
To investigate the diagnostic accuracy of flexirigid thoracoscopy for pleural diseases and the patients' compliance.Forty-seven patients with pleural effusion and thickening of unknown etiology underwent examinations with flexirigid thoracoscopy with subsequent pathological examination, and the diagnostic accuracy and the patients' compliance were observed.Thoracoscopy identified lesions in the pleural and/or diaphragm in 42 patients and no lesions in 5 patients. Malignancy was confirmed in 21 (44.7%), tuberculosis in 17 (36.2%), idiopathic hypereosinophilic syndrome in 1 (2.1%), nocardiasis in 1 (2.1%), constrictive pericarditis in 1 (2.1%), chronic empyema in 2 (4.3%), splenic artery embolization in 1 (2.1%), and negative result in 3 (6.4%) of the cases. The diagnostic accuracy rate of flexirigid thoracoscopy reached 93.6%, and no serious complications in relation to the examination was found.Flexirigid thoracoscopy is efficient and relatively safe for diagnosis of pleural diseases with or without hydrothorax.
Thoracoscopy
Etiology
Cite
Citations (5)
[Objective] To evaluate the use of flexirigid thoracoscopy for diagnosing difficult pleural effusion.[Methods] Fifty-one patients with difficult pleural effusion diagnosed through flexirigid thoracoscopic pleural biopsy were retrospectively studied on its visual aspect under thoracoscopy.[Results] All patients finished flexirigid thoracoscopy examination,thirty-seven malignant tumor and seven tuberculous pleurisy were diagnosed by pathological analysis,only six chronic inflammation,and one case had no problem to be found.Under thoracoscopy:malignant tumor display one or more sarcoidosis,even some sarcoidosis fused into mass;and tuberculous pleurisy showed as small sarcoidosis with diffused pleural congestive and edema,sphacelus might be seen covering the pleura.Haemorrhage was seen in one patient because of tearing up pleural adherent ribbon,and one patient showed blood pressure decreasing to be abnormal transiently,and there was no serious complication.[Conculusions] Flexirigid thoracoscopy pleural biopsy is relatively safe and has very important value in diagnosis of difficult pleural effusion.
Thoracoscopy
Pleurisy
Hemothorax
Cite
Citations (0)
We find pleural effusion in clinical practice frequently. However, it is difficult to make a diagnosis definitively by thoracocentesis or closed pleural biopsy. We directly examine the thoracic cavity by thoracoscopy under local anaesthesia, carry out pleural biopsy and make a definitive pathological diagnosis in pleurisy.A retrospective study of 138 patients who had been diagnosed by thoracoscopy in our hospital was carried out between January 1995 and January 2005.The patients were 114 men and 24 women, ranging in age from 21 to 85 years, with a mean of 59 years. The right side was involved in 83 patients and the left side in 55. The operations took 11-145 min, with a mean of 46 min. Thoracoscopy directly without thoracocenteses was carried out in 28 of 138 patients. Lung cancer with pleural dissemination was diagnosed in 27, malignant pleural mesothelioma in 10, tuberculous pleurisy in 32, non-specific pleurisy in 58, other tumour in 2 and pyothorax in 9 patients. The overall diagnostic efficacy was 97.1% (134/138). The diagnostic efficacy in the cases of carcinoma was 92.6% (25/27), in malignant pleural mesothelioma it was 100% (10/10) and in tuberculosis it was 93.8% (30/32). No major complications occurred during the examination.Pleural biopsy by thoracoscopy under local anaesthesia should be actively carried out in patients with pleurisy, because the technique has a high diagnostic rate and can be easily and safely carried out.
Thoracoscopy
Pleurisy
Pleural cavity
Pleural disease
Cite
Citations (49)
Objective To discuss the clinical significance by medical thoracoscopy in the patients with pleural effusions of unknown aetiology.Methods Clinical data of 135 patients undergoing medical thoracoscopy was retrospectively analyzed.Results Of the 135 cases,their aetiology by pleural biopsy in thoracoscope was diagnosed in 104(77.0%).Of the 104 confirmed cases pathologically,malignancy and tuberculosis cases were respectively in 51(49.0%),and empyema in 2(1.9%).Of the 135 cases with pleural effusion,the positive rate was 85.9% in diagnose of etiology through thoracoscopy.The positive rate was respectively 79.7% and 91.1% for the diagnosis of malignancy and tuberculosis by pleural biopsy in thoracoscope.Conclusion It is of clinical significance by medical thoracoscopy in patients with pleural effusion of unknown aetiology through which pathological and etiological diagnose and accuracy by stages classification of lung cancer is obtained.
Thoracoscopy
Etiology
Clinical Significance
Thoracoscope
Cite
Citations (0)
Objective To investigate the morphological features of tuberculous pleurisy under thoracoscope and evaluate the diagnostic significance of thoracoscope for patients with tuberculous pleurisy.Methods Retrospectively analyzed of the morphological features under thoracoscope and pathological results of 216 patients who had been diagnosed as tuberculous pleurisy,compared thoracoscopy and other diagnostic methods,and its correlation with good curative effect.Results Thoracoscopic presentations of 216 patients with tuberculous pleurisy were hydrothorax,membrana pleuralis hyperaemia,hydrops,effusion,errhysis,anabrosis,formation of fibrous septa or adhesion,diffuse miliary nodules,multiple nodules,nodus coalesce,pachynsis pleurae.Conclusion The morphological features of tuberculous pleurisy are(variable)diversiform,and tuberculosis lesions are non-specific of tuberculous.Thoracoscopy is of great value in the diagnosis for patients with tuberculous pleurisy.
Thoracoscopy
Thoracoscope
Pleurisy
Cite
Citations (0)