Diagnostic yield of thoracoscopic pleural biopsy in undiagnosed exudative pleural effusion and comparative analysis of pleural fluid adenosine deaminase levels.
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace·
- DOI
- 10.4081/monaldi.2026.3910
- PMID
- 42644347
- PMCID
- —
- OpenAlex
- —
- Study type
- Journal article
- Publisher
- Publisher unavailable
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings underscore a viable procedural pathway for resolving diagnostically ambiguous pleural conditions in regions where infectious and neoplastic respiratory diseases carry substantial prevalence.
Structured evidence summary
Research question
This investigation seeks to determine the diagnostic effectiveness of medical thoracoscopy with tissue sampling, alongside evaluating whether pleural fluid enzyme concentrations can differentiate between infectious and neoplastic origins in patients with unresolved exudative effusions.
Study design
Researchers conducted a prospective, single-center observational trial spanning eighteen months at a tertiary medical facility.
Population and setting
The cohort comprised adult participants presenting with unexplained exudative pleural fluid who had previously received negative molecular testing for mycobacterial infection and negative cytological evaluations for cancer across multiple samples.
Main findings
Thoracoscopic tissue collection achieved a ninety-six percent overall diagnostic success rate, identifying malignancy in approximately sixty-nine percent and tuberculosis in roughly twenty-seven percent of cases. Fluid enzyme measurements demonstrated substantially higher values in tuberculous presentations compared to malignant ones, whereas tissue-based molecular assays for tuberculosis yielded low positivity rates. The procedure demonstrated a favorable safety profile with minimal severe adverse events and zero recorded fatalities.
Public-health relevance
The findings underscore a viable procedural pathway for resolving diagnostically ambiguous pleural conditions in regions where infectious and neoplastic respiratory diseases carry substantial prevalence.
Important limitations
The evaluation is restricted to the provided abstract and bibliographic metadata, requiring access to the complete manuscript for decision-grade interpretation. Furthermore, the single-institutional observational framework inherently limits broader generalizability and lacks independent validation cohorts.
GIDS interpretation
This record contributes diagnostic performance metrics relevant to respiratory pathology assessment frameworks. Its classification under tuberculosis diagnostics indicates potential utility for tracking methodological advances in pleural disease evaluation within indexed literature databases.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 5 auditable classifier relationships to diseases, places, topics, and study design.