A study recently published in the European Journal of Cardio-Thoracic Surgery followed patients with “nonspecific pleuritis/fibrosis” biopsy results to observe their long-term outcome and whether malignancy such as mesothelioma was eventually diagnosed.
Malignant mesothelioma is an aggressive form of cancer caused by asbestos exposure. The long latency period associated with the onset of symptoms (between 20 and 50 years) is a major factor why so many patients are diagnosed in a later stage of cancer development. Because current treatment options are largely ineffective, the mesothelioma life expectancy for most patients remains poor.
When a patient is found to have pleural effusion, a medical thoracoscopy is often performed to extract a biopsy sample for testing. The term thoracoscopy refers to a medical procedure where doctors insert a very long, thin tube into the pleural cavity. The tube has mirrors or a very small camera attached to it that allows doctors to see the internal organs and easily collect samples for diagnostic purposes with just a tiny incision and no invasive surgery.
This study included 142 patients who underwent a thoracoscopy in an area with a high incidence of mesothelioma. Those patients with “nonspecific pleuritis/fibrosis” were followed up until death to track any changes in their biopsy results. In 69 percent of patients a definitive diagnosis was recorded. A total of 31 percent (44) of patients had “nonspecific pleuritis/fibrosis.” Of these 44 patients, five went on to be diagnosed with malignant mesothelioma after a mean interval of 9.8 months.
Researchers and doctors could not find the cause of the pleural effusion in 26 of the patients with “nonspecific pleuritis/fibrosis.” Results showed that pleural effusion recurrence was more frequently associated with a false-negative pleural biopsy result.
In conclusion, researchers found “Thoracoscopic pleural biopsy is valuable in the diagnosis of pleural malignancies. Patients with ‘nonspecific pleuritis/fibrosis’ require follow-up as a malignant diagnosis (especially mesothelioma) may eventually be established in approximately 12% of cases.”
Additional information on mesothelioma may be found through the mesothelioma Center.